**Author details**

/

Improvements in glycemic control were achieved, enabling progressive dosage reduction of the other drugs. At the time of publication, at age 5 months, the infant was on minimal doses of hyperglycemic agents and continued to receive twice-daily sirolimus at a dose of 0.3 mg/m2

Recently, exendin-(9-39), a GLP-1 receptor antagonist that raises blood glucose levels in adults, has been introduced as a possible novel therapy for management of hypoglycemia in patients with CHH. However, further studies on its effectiveness and safety are needed [8].

Growth hormone is used in cases of hypoglycemia associated with deficiency of this hormone

In cases of hypoglycemia due to persistent hyperinsulinemic hypoglycemia that does not respond to treatment with diazoxide, glucose, and sirolimus, partial pancreatectomy may be

Recurrent or sustained hypoglycemia can cause neurological damage, mental retardation, epilepsy, and personality disorders [54]. Transient episodes of hypoglycemia are also associ-

Severe hypoglycemia can lead to impairment of cardiovascular function and is associated

Permanent brain damage is found in 25–50% of patients with recurrent severe symptomatic hypoglycemia under age 6 months. Furthermore, hypoxemia and ischemia may potentiate the permanent damage caused by hypoglycemia. The pathological changes described include gyral atrophy, reduced white-matter myelination, and cerebral cortical atrophy. It bears noting that the cerebral infarctions characteristic of hypoxic-ischemic processes are absent in

Newborns with risk factors for neonatal hypoglycemia or those which, although not considered at risk, exhibit poor suckling or inadequate breast milk intake should receive follow-up monitoring and care after hospital discharge, so as to prevent possible undetected

ated with deficits in math learning around age 10 years [26].

hypoglycemia-associated brain injury [51].

**10. Final considerations**

hypoglycemia.

with high rates of neonatal mortality in very low-birth-weight infants [15].

day, without any complications.

76 Selected Topics in Neonatal Care

*8.3.7. Exendin*

*8.3.8. Other drugs*

indicated.

or with hypopituitarism.

**9. Consequences**

Adauto Dutra Moraes Barbosa\*, Israel Figueiredo Júnior and Gláucia Macedo de Lima

\*Address all correspondence to: adutra@globo.com

Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
