Glucose Levels in At-risk Newborns (GLEAN): a prospective cohort study on glucose profiles in infants at risk of hypoglycemia

ObjectiveTo describe glucose patterns in at-risk infants, determine the incidence of hypoglycemia across different risk groups, and evaluate the impact of combined risk factors on odds of developing hypoglycemia.Study designThis prospective cohort study was conducted at KK Women’s and Children’s Hos...

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Main Authors: Fabian Yap, Daniel Chan, Ruther Teo Zheng, Lakshmi Shandra Bos, Victor Samuel Rajadurai, Suresh Chandran
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1599366/full
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author Fabian Yap
Fabian Yap
Fabian Yap
Daniel Chan
Daniel Chan
Daniel Chan
Ruther Teo Zheng
Lakshmi Shandra Bos
Victor Samuel Rajadurai
Victor Samuel Rajadurai
Victor Samuel Rajadurai
Suresh Chandran
Suresh Chandran
Suresh Chandran
author_facet Fabian Yap
Fabian Yap
Fabian Yap
Daniel Chan
Daniel Chan
Daniel Chan
Ruther Teo Zheng
Lakshmi Shandra Bos
Victor Samuel Rajadurai
Victor Samuel Rajadurai
Victor Samuel Rajadurai
Suresh Chandran
Suresh Chandran
Suresh Chandran
author_sort Fabian Yap
collection DOAJ
description ObjectiveTo describe glucose patterns in at-risk infants, determine the incidence of hypoglycemia across different risk groups, and evaluate the impact of combined risk factors on odds of developing hypoglycemia.Study designThis prospective cohort study was conducted at KK Women’s and Children’s Hospital from 16 December 2019 to 16 March 2020, during which 2,564 babies were born. Of these, 701 were identified as at-risk of hypoglycemia based on predefined clinical criteria: infants of diabetic mothers (IDM), term infants with birth weight >4000 g or <2600 g, preterm infants, and infants of obese mothers (IOM). Risk group classification was refined using INTERGROWTH-21st standards, and infants were further stratified by the presence of single or combined risk factors. Complete glucose measurements at 2, 6, 12, 18, and 24 hours were available for 670 infants (95.6%). The primary outcomes were glucose trends and the incidence of hypoglycemia, defined as blood glucose < 3.0 mmol/L.ResultsMean glucose levels stabilized between 3.8 and 4.0 mmol/L by 24 hours. The highest incidence of hypoglycemia was observed in single risk factor SGA infants (22.6%), followed by IOM (16%), a group less studied in hypoglycemia risk assessments. This was comparable to the incidence seen in IDM (13.0%). In contrast, single risk factor LGA infants exhibited the lowest incidence of hypoglycemia (6.2%). Infants with combined risk factors had a higher incidence of hypoglycemia compared to those with a single risk factor (18.5% vs 15.9%) and showed higher odds of hypoglycemia compared to those with a single risk factor (OR 2.47; 95% CI: 0.98–6.08, p = 0.049).ConclusionsGlucose trajectories and hypoglycemia risks differ across clinically defined at-risk groups, underscoring the importance of targeted screening and management protocols. Stratifying infants by single and combined risk factors provided additional insight that may support future refinements to neonatal hypoglycemia clinical guidelines.
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spelling doaj-art-b2d46fddc3bc4b77adec3ddce79a004c2025-08-20T03:59:32ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-08-011610.3389/fendo.2025.15993661599366Glucose Levels in At-risk Newborns (GLEAN): a prospective cohort study on glucose profiles in infants at risk of hypoglycemiaFabian Yap0Fabian Yap1Fabian Yap2Daniel Chan3Daniel Chan4Daniel Chan5Ruther Teo Zheng6Lakshmi Shandra Bos7Victor Samuel Rajadurai8Victor Samuel Rajadurai9Victor Samuel Rajadurai10Suresh Chandran11Suresh Chandran12Suresh Chandran13Endocrinology Service, KK Women’s and Children’s Hospital, Singapore, SingaporeDuke-NUS Medical School, National University of Singapore, Singapore, SingaporeLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, SingaporeEndocrinology Service, KK Women’s and Children’s Hospital, Singapore, SingaporeDuke-NUS Medical School, National University of Singapore, Singapore, SingaporeLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, SingaporeEndocrinology Service, KK Women’s and Children’s Hospital, Singapore, SingaporeDepartment of Neonatology, KK Women’s and Children’s Hospital, Singapore, SingaporeDuke-NUS Medical School, National University of Singapore, Singapore, SingaporeLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, SingaporeDepartment of Neonatology, KK Women’s and Children’s Hospital, Singapore, SingaporeDuke-NUS Medical School, National University of Singapore, Singapore, SingaporeLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, SingaporeDepartment of Neonatology, KK Women’s and Children’s Hospital, Singapore, SingaporeObjectiveTo describe glucose patterns in at-risk infants, determine the incidence of hypoglycemia across different risk groups, and evaluate the impact of combined risk factors on odds of developing hypoglycemia.Study designThis prospective cohort study was conducted at KK Women’s and Children’s Hospital from 16 December 2019 to 16 March 2020, during which 2,564 babies were born. Of these, 701 were identified as at-risk of hypoglycemia based on predefined clinical criteria: infants of diabetic mothers (IDM), term infants with birth weight >4000 g or <2600 g, preterm infants, and infants of obese mothers (IOM). Risk group classification was refined using INTERGROWTH-21st standards, and infants were further stratified by the presence of single or combined risk factors. Complete glucose measurements at 2, 6, 12, 18, and 24 hours were available for 670 infants (95.6%). The primary outcomes were glucose trends and the incidence of hypoglycemia, defined as blood glucose < 3.0 mmol/L.ResultsMean glucose levels stabilized between 3.8 and 4.0 mmol/L by 24 hours. The highest incidence of hypoglycemia was observed in single risk factor SGA infants (22.6%), followed by IOM (16%), a group less studied in hypoglycemia risk assessments. This was comparable to the incidence seen in IDM (13.0%). In contrast, single risk factor LGA infants exhibited the lowest incidence of hypoglycemia (6.2%). Infants with combined risk factors had a higher incidence of hypoglycemia compared to those with a single risk factor (18.5% vs 15.9%) and showed higher odds of hypoglycemia compared to those with a single risk factor (OR 2.47; 95% CI: 0.98–6.08, p = 0.049).ConclusionsGlucose trajectories and hypoglycemia risks differ across clinically defined at-risk groups, underscoring the importance of targeted screening and management protocols. Stratifying infants by single and combined risk factors provided additional insight that may support future refinements to neonatal hypoglycemia clinical guidelines.https://www.frontiersin.org/articles/10.3389/fendo.2025.1599366/fullneonatal endocrinologyhypoglycemiaglucoseneonatologyendocrinology
spellingShingle Fabian Yap
Fabian Yap
Fabian Yap
Daniel Chan
Daniel Chan
Daniel Chan
Ruther Teo Zheng
Lakshmi Shandra Bos
Victor Samuel Rajadurai
Victor Samuel Rajadurai
Victor Samuel Rajadurai
Suresh Chandran
Suresh Chandran
Suresh Chandran
Glucose Levels in At-risk Newborns (GLEAN): a prospective cohort study on glucose profiles in infants at risk of hypoglycemia
Frontiers in Endocrinology
neonatal endocrinology
hypoglycemia
glucose
neonatology
endocrinology
title Glucose Levels in At-risk Newborns (GLEAN): a prospective cohort study on glucose profiles in infants at risk of hypoglycemia
title_full Glucose Levels in At-risk Newborns (GLEAN): a prospective cohort study on glucose profiles in infants at risk of hypoglycemia
title_fullStr Glucose Levels in At-risk Newborns (GLEAN): a prospective cohort study on glucose profiles in infants at risk of hypoglycemia
title_full_unstemmed Glucose Levels in At-risk Newborns (GLEAN): a prospective cohort study on glucose profiles in infants at risk of hypoglycemia
title_short Glucose Levels in At-risk Newborns (GLEAN): a prospective cohort study on glucose profiles in infants at risk of hypoglycemia
title_sort glucose levels in at risk newborns glean a prospective cohort study on glucose profiles in infants at risk of hypoglycemia
topic neonatal endocrinology
hypoglycemia
glucose
neonatology
endocrinology
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1599366/full
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