This document discusses the infant of a diabetic mother. It begins with an introduction stating that this refers to infants born to mothers with high blood glucose levels during pregnancy. It then covers the pathophysiology, explaining how the fetus is exposed to high glucose which can cause hyperplasia of beta cells and fetal hypoglycemia. Complications for the infant include macrosomia, hypoglycemia, and possible congenital anomalies affecting mainly the cardiovascular system. The management of these infants as neonates involves blood sugar monitoring, investigations like CBC and imaging, and treatment of hypoglycemia following specific protocols.

1. Infant of diabetic
mother
1810

2. insights
Introduction
Pathophysiology
Complications
Management
12/08/2021 Infant of diabetic mother 2

3. Introduction
An infant that was born to a mother who
persistently had high glucose blood levels
during pregnancy.
3
 abnormal glucose control of
pregnancy
 Mothers with preexisting diabetes

4. 12/08/2021 4
pathophysiology
Fetus
exposed
to high
blood
glucose
from
mother
Beta cell
hyperplasi
a in fetus
Increased
insulin
Fetal
hypogl
ycemia
MACROSOMIA
Diabetic
mother
Vasculopa
thy in
placental
vessels
Decreased
circulation
and
nutrition to
fetus
IUGR

5. Complications
5
• Macrosomia
• Hypoglycemia
• Hypocalcemia
• Hypomagnesemia
• Respiratory distress syndrome
• Hypoxia → Polycythemia → Thrombotic episodes
• Jaundice
• Decreased Iron

6. Congenital anomalies
Cardiovascular
system (most commonly
affected)
Ventricular septal defects (most
common)
Hypertrophic obstructive
cardiomyopathy or asymmetrical
septal hypertrophy (more specific for
IDM)
Transposition of great vessels
Other anomalies
• Sacral agenesis → caudal agenesis
syndrome (most specific for IDM)
• Anencephaly
• Spina bifida
• Lazy left colon syndrome→Appears as
pseudo obstruction
• Neural tube defects
6

7. Management in neonate
Investigations
•Blood sugar level monitoring (first 48 hours)
•CBC
•CXR
•Serum bilirubin, calcium, magnesium
•Vertebral radiography
•Barium enema
12/08/2021 7

8. AIIMS NICU Protocol for management of
neonatal hypoglycemia
12/08/2021 8
Symptomatic Asymptomatic
10% dextrose bolus
2ml/kg
Blood glucose level
<20mg/dl
Blood glucose level
20-45mg/dl
Glucose drip
Glucose Infusion rate 6mg/kg/min
• Breast feeds
• Reassess after
one hour
If no response – increase glucose infusion rate to
12mg/kg/min
If still no response – IM glucagon or diazoxide

9. The way to get started is
to quit
talking and begin doing.
9
Walt Disney
Thank you