A STUDY OF INCIDENCE OF

HYPOGLYCEMIA AND HYPOCALCEMIA

IN INFANTS BORN TO DIABETIC
MOTHERS AND A CORRELATION
WITH MATERNAL THIRD TRIMESTER
GLYCEMIC CONTORL
T.PARDHA SARADHI
1ST YEAR PEDIATRICS PG
INTRODUCTION
• INCIDENCE OF ANATOMICAL AS WELL AS METABOLIC
COMPLICATONS IN INFANTS BORN TO DIABETIC MOTHER
ARE INCREASING

• MOST OF THEM ARE DUE TO POOR GLYCEMIC CONTORL

DURING THIRD TRIMESTER

• HYPOGLYCEMIA IS SEEN IN 25-40% OF BABIES BORN TO

DIABETIC MOTHER
STRUCTURAL COMPLICATIONS METABOLIC COMPLICATIONS
• NEURAL TUBE DEFECTS • HYPOGLYCEMIA
• DUODENAL ATRESIA • HYPOCALCEMIA
• CARDIOVASCULAR DISEASES • HYPERBILIRUBINEMIA

• POOR GLYCEMIC CONTORL IN 1ST • POOR GLYCEMIC CONTORL IN

TRIMESTER 3RD TRIMESTER
•AIM
• TO EMPHASISE THE IMPORTANCE OF THIRD TRIMESTER
GLYCEMIC CONTORL TO PREVENT METABOLIC COMPLIONS

• CORRELATION BETWEEN MATERNAL 3RD TRIMESTER HBA1C

VALUE IN DIABETIC MOTHER AND INCIDENCE OF
HYPOGLYCEMIA AND HYPOCALCEMIA IN BABIES BORN TO THEM
• MOTHERS HAVING FASTING BLOOD GLUCOSE MORE THAN
90mg/dl AND POSTPRANDIAL BLOOD SUGAR MORE THAN
120mg/dl WERE DIAGNOSED TO HAVE DIABETES
• INCULSION CRITERIA
• ANTENATAL MOTHERS WITH GESTATIONAL AND PRE
GESTATIONAL DIABETES AND NEONATES BORN TO THEM
• EXCULSION CRITERIA
1. PRETERM AND IUGR NEONATES BORN TO DIABETIC MOTHER
2. NEONATES WHO HAD BIRTH ASPHYXIA
3. NEONATES WHO HAD CONGENITAL ANAMOLIES WHICH
SHOWED POOR 1ST TRIMESTER GLYCEMIC CONTORL
WORK UP
• BLOOD SAMPLE FROM 3RD TRIMESTER MOTHER FOR HBA1C
ESTIMATION

• BLOOD SAMPLES FROM BABY AT 1 HOUR,2 HOUR,6 HOUR,12

HOUR,24 HOUR FOR ESTIMATING BLOOD SUGAR VALUES BY
GLUCOSE OXIDASE TEST

• BLOOD SAMPLE FOR ESTIMATION OF IONISED CALCIUM BY ION

SELECTIVE ELECTRODE TECHNIQUE AT 24TH HOUR OF LIFE
• BLOOD SUGAR LESS THAN 45mg/dl IS CONSIDERD AS
HYPOGLYCEMIA AND IT IS TAKEN AS CUT OFF VALUE AND
SERUM IONISED CALCIUM LEVLES LESS THAN 4mg/dl WAS TAKEN
AS HYPOCALCEMIA CUT OFF VALUE

• HBA1C LESS THAN 6.1 IS TAKEN AS HAVING GOOD GLYCEMIC

CONTORL AND IT IS TAKEN AS CUT OFF VALUE

• HBA1C LEVLES OF MOTHER CAN BE USED AS SCREENING

MARKER TO MONITOR,ANTICIPATE HYPOGLYCEMIA EPISODES OF
NEWBORN
STATISTICAL ANALYSIS
• DATA COLLECTED AND ENTER IN MICROSOFT EXCEL AND
ANALYSED USING SSPS SOFTWARE

• PERCENTAGES,PROPORTIONS AND MEAN VALUES ARE

DERIVED

• ONE WAY CHI-SQUARE TEST SHOLUD BE USED

LIMITATIONS
• GLYCEMIC CONTORL OF MOTHERS IN 1ST AND 2ND TRIMESTER
WERE NOT INCULDED

• FOETAL INSULIN LEVELS IN CORD BLOOD SAMPLE TO

CONFORM HYPERINSULINEMIA

• THIS STUDY HAS NOT FOCUUSED ON GLYCEMIC CONTORL

AND ITS COREELATION WITH CONGENITAL MALFORMATIONS
CONCULSION
COMPLICATIONS IN NEW BORN ,BORN TO DIABETIC MOTHER ARE
PREVENTABLE PROBLEMS

HYPOGLYCEMIA IS MOST COMMON METABOLIC

COMPLICATION IN INFANTS BORN TO DIABETIC MOTHER AND
CORRELATES WITH 3RD TRIMESTER GLYCEMIC CONTORL

EARLY RECOGNITION AND PROMPT MANAGEMENT OF

COMPLICATIONS AS PER GUIDELINES REDUCE MORTALITY AND
MORBIDITY AMONG BABIES OF DIABETIC MOTHERS
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