What are the other Names for this Condition? (Also known as/Synonyms)

• High Blood Sugar in Infants
• Hyperglycemia in Newborns
• Neonatal Hyperglycemia

What is Hyperglycemia in Infants? (Definition/Background Information)

• Hyperglycemia in Infant is a very common abnormality seen in the metabolism of prematurely born and critically ill newborn children
• Hyperglycemia is defined as the presence of high levels of glucose (sugar) in blood. The condition occurs due to the lack of sufficient levels of insulin in the body
• Hyperglycemia in Infants can be the result of gestational diabetes mellitus (a form of type II diabetes) that develops in the mother during pregnancy
• The signs and symptoms of Neonatal Hyperglycemia may not be apparent during the initial period following birth. The indications of the condition may include frequent urination, dehydration, and increased thirst
• Undiagnosed and/or untreated hyperglycemia can result in complications such as nerve damage, kidney damage, impaired vision, and greater vulnerability to type II diabetes and heart conditions
• The mainstay of treatment of Hyperglycemia in Infants is using insulin therapy. With early and adequate treatment of the condition, the prognosis is generally good. In most cases, no long-term effects on the child is noted

Who gets Hyperglycemia in Infants? (Age and Sex Distribution)

• Hyperglycemia in Infants is seen in both term and preterm infants. This form of hyperglycemia (or high blood sugar) is seen in infants shortly after birth; from birth to one month of age
• Both sexes are equally likely to develop Hyperglycemia. The gender of the baby has no effect on the development of this condition
• All racial and ethnic groups are generally affected
• In general, North America has the highest prevalence of diabetes (high blood sugar), followed by the Middle East and North Africa. This corresponds to an increased risk of Hyperglycemia in Infants, because in areas with high prevalence of diabetes, the risk of the mother developing gestational diabetes mellitus and the infant developing hyperglycemia is higher

What are the Risk Factors for Hyperglycemia in Infants?  (Predisposing Factors)

The risk factors for Hyperglycemia in Infants include the following:

• Prematurity: Infants that are born prematurely (short gestational period) have a higher risk of developing hyperglycemia. This is a risk factor because prematurely born infants are typically given glucose infusions, especially those infants who have low weight at birth. Due to these glucose infusions, the risk for high blood sugar increases, as the infants typically cannot produce enough insulin to keep blood sugar levels low
• Stress: Stress is another risk factor for Hyperglycemia in Infants, because the typical stress response to critical illness (often seen in preterm infants) includes the release of certain hormones such as epinephrine and norepinephrine. This can result in high blood sugar levels and the development of hyperglycemia
• Certain drugs such as glucocorticoid therapy: In infants that are born with very low birth weights, glucocorticoid therapy is a common treatment. Glucocorticoids are hormones that can also lead to increased blood sugar, thereby increasing the risk for Hyperglycemia in Infancy
• Development of neonatal diabetes mellitus (in rare cases): Although rare, neonatal diabetes mellitus can occur during the first 6 months of life. Neonatal diabetes mellitus is a risk factor associated with Neonatal Hyperglycemia
• Gestational diabetes mellitus (GDM) is most commonly seen in women of Asian and Latina/Hispanic ethnic background. Because GDM can result in Hyperglycemia in Infants, infants born to mothers of Asian or Hispanic ethnic background generally have a higher risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hyperglycemia in Infants? (Etiology)

The cause of hyperglycemia (or high blood sugar), in general, is the lack of enough insulin in the body. Insulin is a hormone that is responsible for regulating blood sugar levels.

• A common cause of Hyperglycemia in Infants is gestational diabetes mellitus (GDM) that develops in the mother during pregnancy
  • Some hormones associated with pregnancy can cause poor cellular uptake of glucose from the bloodstream because of interference with the insulin response
  • Since the mother and the baby share a common blood supply, high blood sugar in the mother leads to high blood sugar in the fetus
  • As a result, GDM is often a cause of Hyperglycemia in Infants, because infants are born with high blood sugar levels
• Another cause of Hyperglycemia in Infants is the release of hormones epinephrine and norepinephrine
  • The release of these hormones is typical during a stress response and in infants, who are critically ill or having a low birth weight; the stress response results in release of these hormones
  • These hormones promote the liver to release glucose into the bloodstream (by breaking down stored glycogen), which causes high blood sugar levels, thus leading to hyperglycemia
• Another cause of Hyperglycemia in infants is neonatal diabetes mellitus (which is a rare condition)
  • Neonatal diabetes mellitus is diabetes in the infant during the first 6 months of life. It is caused when the infant cannot produce enough insulin
  • Low insulin levels lead to high blood glucose levels and this is another cause for Hyperglycemia in Infants

What are the Signs and Symptoms of Hyperglycemia in Infants?

• The signs and symptoms of Hyperglycemia in Infants include frequent urination (and in large amounts), dehydration, and increased thirst
• Often, infants with hyperglycemia may show no symptoms or display a delayed onset of the symptoms

How is Hyperglycemia in Infants Diagnosed?

The diagnosis of Hyperglycemia in Infants includes taking a thorough history of the infant and his/her family and a full physical examination.

• If a healthcare provider suspects hyperglycemia, then further tests are performed to establish the diagnosis
• To confirm a diagnosis of hyperglycemia, a blood test may be performed. Using a heel stick or finger-stick method, a small amount of blood is drawn from the infant. The blood is tested for glucose levels and if the glucose levels are high, a diagnosis of hyperglycemia can be confirmed

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hyperglycemia in Infants?

If left treated, hyperglycemia can lead to complications such as:

• Increased risk for developing cardiovascular disease and type II diabetes mellitus later in life
• Nerve damage resulting in abnormal functioning of the nerve (a condition is known as neuropathy)
• Possible blindness because of damage to the blood vessels in the eye
• Bone and joint problems later in life
• Kidney damage
• Tissue damage because of poor blood flow

Note: All the complications listed above are associated with hyperglycemia. In infants who have hyperglycemia and who are not diagnosed or treated, the above complications could potentially develop later in their life. The complications are very similar to those seen in individuals with type I or type II diabetes mellitus.

How is Hyperglycemia in Infants Treated?

The treatment of Hyperglycemia in Infants is through insulin therapy.

• Administration of insulin in infants improves the uptake of glucose by the cells, which lowers blood sugar levels. Insulin therapy also promotes growth and calorie intake, which is important in these infants because they are typically born at a low birth weight
• A very short-term treatment of Hyperglycemia in Infants is reducing the rate of glucose infusion. In infants that are born at a low birth weight, glucose is typically administered through an IV (intravenous) supply to help supply nutrients and to promote growth. Nevertheless, if the infant receives glucose too quickly (a high glucose infusion rate) and does not have enough insulin to regulate blood sugar levels, blood sugar levels will remain high

How can Hyperglycemia in Infants be Prevented?

Hyperglycemia prevention factors depend on the cause of Hyperglycemia in the infant.

• Appropriate prenatal care decreases the risk for a premature or preterm birth, which is a very important consideration with regards to Hyperglycemia in Newborns
• Preventing a premature birth is a definite step in helping prevent the infant from developing hyperglycemia. The expectant mother should refrain from smoking or drinking alcohol and strictly follow the recommendations of the healthcare provider involved in providing prenatal care
• Preventing a low birth weight is another step towards preventing Hyperglycemia in Infancy. Ensuring proper calorific food intake rich in nutrients during pregnancy can help the fetus grow normally, thus reducing the risk of a low birth weight
• Another significant factor to prevent hyperglycemia is for the expectant mother to eat a healthy and balanced diet that is low in fats and high in fiber, to prevent developing gestational diabetes mellitus. The mother should also perform light exercise and physical activity to prevent GDM. Because GDM is a risk factor of Hyperglycemia in Infants, lowering risk of GDM lowers the risk of hyperglycemia in the child

What is the Prognosis of Hyperglycemia in Infants? (Outcomes/Resolutions)

• If Hyperglycemia in the Infant is treated early enough, the prognosis is generally good
• If, however, the high blood sugar levels are left untreated, then the infant has a future risk of developing type II diabetes mellitus
• Typically, there are no long-term effects of hyperglycemia on the child, unless the child develops juvenile diabetes

Additional and Relevant Useful Information for Hyperglycemia in Infants:

• Gestational diabetes is a type of diabetes in which women have glucose intolerance, during pregnancy. It is characterized by a high blood sugar, first diagnosed during pregnancy

The following article link will help you understand gestational diabetes:

http://www.dovemed.com/diseases-conditions/gestational-diabetes/