Neonatal Hypoglycemia Thresholds and Management — free guideline decision tool

This tool gives age-stratified operational glucose thresholds and targets for at-risk newborns, combining AAP 2011 transitional thresholds with PES treatment targets.

Symptomatic + glucose → IV glucose emergency. AAP thresholds: < 4 h, 4–24 h (feed, recheck, IV glucose if persistent). PES targets: > 2.8 first 48 h, > 3.3 after 48 h, > 3.9 if suspected congenital disorder.

Use when screening or managing glucose in at-risk newborns (preterm, SGA, LGA, infant of a diabetic mother, perinatal asphyxia) in the first days of life.

Symptomatic hypoglycemia is a neurologic emergency requiring immediate IV dextrose and a search for the cause. Thresholds are operational, not a unified gold standard; management prioritizes early feeding and rechecking before escalating to IV glucose. Persistent inability to maintain targets, or hypoglycemia beyond 48 hours, prompts investigation for a congenital disorder with critical samples drawn before discharge.

For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.

Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.

Inputs: Postnatal age 4–24 hours, Blood glucose 2.0 mmol/L, Hypoglycemia symptoms (tremor / irritability / apnea / seizures / lethargy / poor feeding) Asymptomatic → Result: Glucose 2 mmol/L (36 mg/dL)（Threshold/target for this window: Intervention/target: AAP operational threshold (pending update) (intervention threshold); current 2 mmol/L → low, needs management, Management direction: Asymptomatic at-risk: feed early and recheck against the AAP operational threshold (values pending update, not shown); still low on recheck → IV glucose, PES target summary: At-risk infant without congenital disease: > 2.8 (50) in the first 48 h, > 3.3 (60) after 48 h; suspected congenital hypoglycemia disorder > 3.9 (70)） Inputs: Postnatal age > 48 hours, Blood glucose 2.0 mmol/L, Hypoglycemia symptoms (tremor / irritability / apnea / seizures / lethargy / poor feeding) Symptomatic → Result: Management IV glucose (emergency)（Determination: Symptomatic hypoglycemia with glucose 2 mmol/L (36mg/dL) → emergency, immediate IV glucose (targeting normal glucose and resolution of symptoms), Note: Neuroglycopenic symptoms (tremor/irritability/apnea/seizures/lethargy) warrant IV correction and a search for the cause; recheck to confirm, Basis: AAP 2011; PES 2015）