High blood sugar, or hyperglycemia, is an uncommon condition in infants. It usually results from either prematurity, infection, inflammation or therapies used in premature or malnourished infants, such as infants receiving intravenous glucose infusions in a neonatal intensive care unit. Frequent monitoring is important in infants with hyperglycemia to prevent long-term complications.
Causes
Premature infants often lack the developmental ability to feed appropriately and sustain their energy requirements. Another problem is that premature infants are not born with enough glucose stores to maintain their energy needs, which sometimes results in hypoglycemia, or low blood sugar. According to the Merck Manuals, hyperglycemia can result from too high concentration of sugar of intravenous fluids. Hyperglycemia can also result from any stressful situation that increases the production of steroids, which help the infant fight off infections and inflammation and which can increase blood sugar levels.
Symptoms
Infants with high blood sugar often do not exhibit any symptoms. If the high blood sugar level is longstanding, the infant can become dehydrated. This happens as the high levels of sugar in the bloodstream overwhelm the kidney's ability to retain glucose in the body. The glucose starts filtering out into the urine, dragging fluids with it and increasing the amount of urine production, which can result in dehydration. Infants with dehydration can have increased heart rate, sunken anterior fontanel or skull soft spot, dry lips and mucous membranes and dry skin. The urine can become concentrated, giving it a bright orange or yellow appearance.
Diagnosis
The diagnosis of hyperglycemia is made by blood and urine tests. Bedside glucose monitoring devices are used routinely to measure newborn infants' blood sugar level, but according to the FDA, care must be taken that the devices are approved and calibrated for infants. If the level measured is abnormally high, a serum sample should be obtained and sent to the lab for confirmation. The presence of glucose in the urine can also alert to the presence of high blood sugar.
Treatment
If an infant with a high blood sugar level is receiving intravenous fluids containing glucose, the infusion should be stopped. Once the level deceases to the normal range, the infusion can be restarted, but with a lower concentration of glucose in the fluid. In severe cases, or infants exhibiting symptoms, insulin can be used to lower the blood glucose level. Frequent monitoring is necessary, as the sugar can drop precipitously and then cause hypoglycemia, or low blood sugar.
Warning
According to the book "Avery's Diseases of the Newborn," several studies have linked the presence of hyperglycemia in very low birth weight premature infants with intraventricular hemorrhages, or bleeding inside the ventricles of the brain. Intraventricular hemorrhage can increase the mortality of premature infants and lead to severe developmental deficiencies. Bleeding in the brain due to high blood sugar can also lead to seizures.
