Glucose Screening in Late Preterm and Term SGA

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Screening of Glucose in Late Preterm and Term SGA, IDMA/LGA Infants Protocol

7.2.14 kjm with LT

For late preterm infants 34-36 weeks and SGA infants, screen for 0-24 hours

For IDM and LGA>34 weeks, screen for 0-12 hours

IF PATIENT HAS SYMPTOMS OF HYPOGLYCEMIA AT ANY TIME: OBTAIN BEDSIDE GLUCOSE AND CALL PHYSICIAN FOR GLUCOSE OF < 40

Symptoms of hypoglycemia include: Irritability, tremors, jitteriness, exaggerated Moro reflex, high pitched cry, seizures, lethargy, floppiness, cyanosis, apnea, poor feeding

FOR ASYMPTOMATIC INFANTS Birth to 4 hours of age:

  • Give initial feed within 1 hour and screen blood glucose 30 minutes after first feed.
  • If initial screen is < 25mg/dL then feed again and recheck glucose in 1 hour.
  • If screen after second feeding is still <25, call physician for IV glucose orders.
  • If screen after second feeding is 25-40mg/dL re-feed and continue monitoring.
  • Target glucose screen is > 45 mg/dL prior to feeds

FOR ASYMPTOMATIC INFANTS 4-24 hours of age:

  • Continue feeds every 2-3 hours.
  • Screen glucose prior to each feed.
  • If glucose before a feed is < 35mg/dL , feed again and recheck glucose in 1 hour.
  • If glucose screen is still < 35, call physician for IV glucose orders.
  • If glucose screen is still 35-45mg/dL re-feed and continue glucose monitoring.
  • Target glucose is > 45 mg/dL prior to routine feeds

IDM/LGA infant glucose screening can be discontinued after 12 hours if target glucose is met.

Late Preterm and Term SGA infants may have their glucose screening discontinued after 24 hours if the target glucose is met.