A newborn of a diabetic mother is at risk for which metabolic issue after birth?

• A. Hypoglycemia due to persistent hyperinsulinemia; monitor glucose and treat.
• B. Hyperglycemia due to persistent insulin resistance.
• C. Hypocalcemia due to maternal hypoparathyroidism.
• D. Hyperkalemia due to renal impairment.

Answer: (A)

Newborns of diabetic mothers are at risk for low blood sugar after birth because the fetus experiences high glucose levels in utero, which stimulates the pancreas to make extra insulin. Once the baby is born, the maternal glucose supply stops, but insulin levels can remain elevated, driving glucose into cells and lowering the blood glucose level. This hypoglycemia can present with jitteriness, poor feeding, lethargy, or temperature instability, and it’s important to detect it early.

Monitoring blood glucose promptly after birth and treating with early feedings is the first step. If blood glucose remains low or the infant is symptomatic, intravenous dextrose is used to rapidly raise blood glucose and prevent neurological complications. The pattern typically improves as insulin levels fall over the next several hours to days.

Other options don’t fit this scenario because hyperglycemia isn’t the usual issue in these newborns, and while hypocalcemia or hyperkalemia can occur in some infants, they are not the primary metabolic risk associated with maternal diabetes.