In 2009, the Eunice Kennedy Shriver National Institute of Child Health and Human Development reported on a 2008 conference, “Neonatal Hypoglycemia,”1 noting that “There has been no substantial evidence-based progress in defining what constitutes clinically significant but transient neonatal hypoglycemia,” “There is no evidence-based study to identify any specific plasma glucose concentration (or range of glucose values) to define pathologic ‘hypoglycemia,’” and “Research studies are needed to fulfill this basic gap in knowledge and to help demonstrate the relationship between plasma glucose concentrations during the neonatal period and later neurological outcomes.” Since that report, there still are no prospective controlled trials to assess risks of any “low” glucose concentrations, their duration, their relationship to other concurrent pathology, or whether treated or untreated, the outcomes differ in any population of newborn infants.

The significance of early postnatal low glucose concentrations, therefore, and their optimal management remain poorly defined. Especially problematic...

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