Neonatal Hypoglycemia Wheel

This wheel provides a practical guide and algorithm for screening and subsequent management of neonatal hypoglycemia with a goal target glucose screen ≥45 mg/dL prior to routine feedings. Initial screen for hypoglycemia is 30 minutes after the first feeding. For infants who are 4-24 hours old, feeding is typically every 2-3 hours with glucose screen prior to each feeding. In a symptomatic infant with blood glucose level of less than 40 mg/dL, IV glucose infusion is indicated. Whenever neonatal hypoglycemia is suspected, plasma or blood glucose is required to accurately measure serum levels without relying exclusively on test glucose strips. Test strips demonstrate a reasonable correlation with actual plasma glucose concentrations, but the variation from actual level may vary by 10-20 mg/dL and greatest at low glucose levels.

The wheel has 4 circles that are all color coded for easy reading. Start at the center circle and move outward as you assess the patient and each condition. This wheel is applicable to the following infants only: LPI/SGA/LGA/IDM

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