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Abstract
Severe glucose deficiency leads to cerebral energy failure, impaired cardiac performance,
muscle weakness, glycogen depletion, and diminished glucose production. Thus, maintenance
of glucose delivery to all organs is an essential physiological function. Normal term
infants have sufficient alternate energy stores and capacity for glucose production
from glycogenolysis and gluconeogenesis to ensure normal glucose metabolism during
the transition to extrauterine life and early neonatal period. Milk feedings particularly
enhance glucose homeostasis. Energy sources often are low in preterm and growth restricted
infants, who are especially vulnerable to glucose deficiency. Plasma glucose concentration
is the only practical measure of glucose sufficiency, but by itself is a very limited
guide. Key to preventing complications from glucose deficiency is to identify infants
at risk, promote early and frequent feedings, normalize glucose homeostasis, measure
glucose concentrations early and frequently in infants at risk, and treat promptly
when glucose deficiency is marked and symptomatic.
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