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Neonatal Hypoglycaemia in IDM — RACP Paediatrics MCQ

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ModerateEndocrinologyNeonatal Hypoglycaemia in IDMRACP Paediatrics

A 2-day-old term neonate has a blood glucose of 1.8 mmol/L. He is jittery, feeding poorly, and had a birth weight of 5.2 kg. His mother has gestational diabetes. What is the mechanism of hypoglycaemia?

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Correct answer: E — Hyperinsulinism secondary to maternal hyperglycaemia

Infants of diabetic mothers develop fetal hyperinsulinism in response to maternal hyperglycaemia. After birth, insulin levels remain elevated while glucose supply ceases, causing hypoglycaemia. These infants are also at risk of macrosomia, birth injuries, polycythaemia, and hypertrophic cardiomyopathy.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Neonatal Hypoglycaemia