Objective
This study aimed to evaluate the efficacy and safety of continuous intravenous (IV) glucagon infusion in the management of neonatal hypoglycemia in infants of diabetic mothers (IDMs).

Study Design
This retrospective case–control study included IDMs treated for hypoglycemia at Turku University Hospital, Finland, over 11 years. Sixteen infants received IV glucose and continuous IV glucagon, while 26 matched controls received IV glucose only.

Results
Prior to glucagon initiation, cases had higher IV glucose requirements and lower plasma glucose levels than controls. Following infusion, plasma glucose normalized rapidly. The mean (SD) duration of glucagon treatment was 5.6 (1.2) days. Maternal prepregnancy body mass index (BMI) was significantly higher in cases (mean = 35.0 kg/m2 [SD = 8.2 kg/m2]) than in controls (mean = 27.6 kg/m2 [SD = 7.1 kg/m2]), p = 0.006. No significant differences in adverse effects were observed.

Conclusion
Continuous IV glucagon infusion is an effective and safe treatment for refractory hypoglycemia in IDMs.

Key Points
-There are limited data on glucagon use in neonatal hypoglycemia.
-Newborns of diabetic mothers could be a target population.
-Glucagon infusion may be a valuable adjunctive therapy.