Should routine peripheral blood glucose testing be done for all newborns at birth?

PURPOSE: To determine the (1) incidence of peripheral blood glucose (PBG < 40 mg/dL) in infants within 2 hours of birth and (2) validity of using maternal and infant risk factors and/or infant signs/symptoms of hypoglycemia as a screen for PBG < 40 mg/dL. STUDY DESIGN: Descriptive study with a convenience sample of 220 mother-infant dyads admitted to a mother-baby unit. Maternal and infant risk factors and infant signs/symptoms of hypoglycemia were assessed, and a PBG value was obtained within 2 hours of birth from the infant. Data were analyzed with descriptive statistics, multiple regression analysis, and sensitivity and specificity testing. RESULTS: The incidence of PBG < 40 mg/dL was 5.1% (N = 10 of 198). Fifteen maternal/infant risk factors were found; 2 of the 23 risk factors predicted PBG values within 2 hours of birth at a statistically significant level (jitteriness [p = .011] and tachypnea [p = .033]). Sensitivity was 71.9% and specificity 44.7% for using the presence of at least one maternal/infant risk factor and/or infant signs/symptoms of hypoglycemia to correctly identify PBG < 40 mg/dL within 2 hours of birth. CLINICAL IMPLICATIONS: Nurses working with mothers and infants can use the data from our study along with the recommendations from professional organizations such as American Academy of Pediatrics to begin a conversation at their institutions about revising protocols for routine PBG testing. Screening infants for maternal/infant risk factors and infant signs/symptoms of hypoglycemia could be used instead to safely decrease by 45% the number of infants who would need to have a PBG sample obtained within 2 hours of birth.

Sensores de glucosa con información en tiempo real. GUARDIAN RT™/PARADIGM RT™ / Glucose Sensors which provide real time information. GUARDIAN RT™/PARADIGM RT™

Este trabajo amplía el póster que fue presentado al Encuentro Internacional de Educadores en Diabetes en Cádiz, 24-25 de mayo de 2007. En él se explica un programa específico estructurado para la colocación y retirada del sistema de monitorización de glucosa en tiempo real Guardian RT'99 así como para el adiestramiento de cara a utilizar la información en tiempo real por el paciente y retrospectivamente por el equipo de la Unidad de Diabetes(AU)

This report amplifies the poster which was presented at the International Meeting of Diabetes Educators which took place in Cadiz on May 24-25 in 2007. In this report, the authors explain a specific program structured to insert and remove a glucose monitoring real time system called Guardian RT'99, plus the authors provide an explanation how to properly use the real time information which this monitoring system provides to patients and to the Diabetes Ward medical team respectively(AU)