Topics Discussed: hematology; hyperglycemia; hyperglycemia, neonatal.
Excerpt:"Problem. The nurse reports an infant has a blood glucose level of 240 mg/dL. Hyperglycemia is defined as a whole blood glucose level >120–125 mg/dL or a plasma glucose concentration >145–150 mg/dL regardless of gestational or postnatal age or weight. One review also suggests that a blood glucose of 
216 mg/dL in extremely low birthweight (ELBW) infants as a definition of neonatal hyperglycemia due to the risk of osmotic diuresis. There is an association between hyperglycemia and increased morbidity and mortality.
Immediate questions
- What is the serum glucose value on laboratory testing? Dextrostix values are often inaccurate because the procedure is performed incorrectly or the strips are old and no longer reliable. Chemstrip-bG values are thought to be more reliable by some, but it is best to obtain a serum glucose level from the laboratory before initiating treatment.
- Is glucose being spilled in the urine? A trace amount of glucose in the urine is accepted as normal. If the urinary glucose level is +1, +2, or greater, the renal threshold has been reached with an increased chance of osmotic diuresis. Some institutions accept a urinary glucose level of +1 without treating the patient (controversial). Others feel that the presence of >1% of glucosuria suggests..."
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