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Abstract

We appreciate the interest of Thornton et al in the findings of the GLOW study. We entirely agree that our study reports findings from healthy babies, and that these cannot be extrapolated to drawing conclusions about management of babies at risk of hypoglycemia. Although we have placed our findings about glucose concentrations in the context of several international guidelines for treatment of at-risk babies, including those from the Pediatric Endocrine Society,1Thornton P.S. Stanley C.A. De Leon D.D. Harris D. Haymond M.W. Hussain K. et al.Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children.J Pediatr. 2015; 167: 238-245Abstract Full Text Full Text PDF PubMed Scopus (278) Google Scholar and have noted that low glucose concentrations are common in healthy babies, we do not suggest this might indicate a change in the care of at-risk babies. This is why we have stated that, “We are unable to determine if … low glucose concentrations in healthy babies … may be associated with impairments in later childhood.” Until additional data are available, clinicians should continue to rely on existing guidelines for management of babies at risk of neonatal hypoglycemia. The GLOW Study does not light up the true Pediatric Endocrine Society recommendations for management of hypoglycemia in newbornsThe Journal of PediatricsVol. 225PreviewUsing intermittent plasma glucose testing combined with continuous interstitial glucose monitoring, Harris et al1 demonstrate with unprecedented clarity, patterns of glucose concentrations in the first days of life in healthy term newborns. After a transitory decline following separation from the placenta, glucose concentrations increase in the first 18 hours, remaining stable at 59 ± 11 mg/dL for 48 hours, then rising to a new plateau of 83 ± 13 mg/dL by day 4. The authors report that by 72 hours a significant proportion of normal babies had at least one glucose concentration below the Pediatric Endocrine Society (PES) thresholds for managing at-risk babies. Full-Text PDF