Hypoglycemia and Hyperglycemia in the Neonate

Credit

Speaker

Julia Muzzy Williamson, PharmD, BCPPS, BCNSP, C-ELBW Related seminars and products

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Julia Muzzy Williamson, PharmD, BCPPS, BCNSP, C-ELBW, is an assistant professor of practice at North Dakota State University and a pediatric clinical pharmacist currently practicing in the neonatal intensive care unit at Sanford Health in Fargo. At NDSU, she instructs students in the Doctor of Pharmacy program on topics including nutrition, pediatrics, and women’s health. She also mentors pharmacy students in research projects focused on breastfeeding and clinical practice in the NICU. Her practice in the NICU focuses on nutrition in the smallest patients including management of complex patients with short gut, parenteral nutrition dependence and complications, and micronutrient management. Dr. Muzzy is currently dual board certified as a Pediatric Pharmacotherapy Specialist and Nutrition Support Pharmacist.

Speaker Disclosures:
Financial: Julia Muzzy Williamson has employment relationships with North Dakota State University and Sanford Health. She receives a speaking honorarium from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Julia Muzzy Williamson has no relevant non-financial relationships.

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Objectives

1. Differentiate between the pathophysiology of neonatal hyperglycemia and hypoglycemia.
2. Develop a management approach for neonatal hyper/hypoglycemia.
3. Determine the complications of neonatal hyper/hypoglycemia.
4. Integrate current interprofessional guidelines to improve outcomes for patients with neonatal hyper/hypoglycemia.

Outline

• Hyperglycemia
  • Etiology
    • Prematurity and Intrauterine growth restriction
    • Increased stress hormones
    • Causes related to feeding/total parenteral nutrition (TPN)
    • Sepsis
    • Iatrogenic
    • Transient neonatal diabetes mellitus
    • Drugs
  • Evaluation
  • History and Physical
  • Workup
  • Glucose
  • Electrolytes
  • Differential Diagnoses
  • Treatment and Management - Interdisciplinary
  • Glucose Infusion Rate (GIR)
  • Role of Insulin
• Hypoglycemia
  • Etiology
    • Insufficient glucose supply, with low glycogen or fat stores or poor mechanisms of glucose production
    • Increased glucose utilization (excessive insulin production or increased metabolic demand)
    • Failure of counter-regulatory mechanisms
  • Evaluation
  • History and Physical
  • Workup
  • Differential Diagnoses
  • Treatment and Management - Interdisciplinary
  • Early feeding
  • Intravenous dextrose
  • Second line - corticosteroids

Target Audience

• Nurses
• Nurse Practitioners
• Occupational Therapists
• Occupational Therapy Assistants
• Physical Therapists
• Physical Therapy Assistants
• Physician Assistants
• Speech Language Pathologists
• Other Professions