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Neonatal hypoglycaemia — MRCPCH FOP MCQ

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ModerateNeonatologyNeonatal hypoglycaemiaMRCPCH FOP

A 3-hour-old baby of a mother with gestational diabetes is jittery and has poor feeding. Capillary glucose is 1.8 mmol/L and examination is otherwise normal. What is the most likely cause?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Transient hyperinsulinaemia after maternal diabetes

Infants of diabetic mothers are at risk of early hypoglycaemia due to fetal hyperinsulinaemia after maternal glucose exposure. Congenital adrenal hyperplasia can cause hypoglycaemia but would more often be associated with salt-wasting or genital findings. Inborn errors are considered with persistent or recurrent hypoglycaemia, acidosis or hyperammonaemia. The pearl is that feeding difficulty and jitteriness in a risk-group neonate require prompt glucose testing.

Reference: BAPM Identification and management of neonatal hypoglycaemia