The response from Dr Hay and his esteemed colleagues raises a valid concern and misinterpretation of my commentary, and I am very grateful for their prudent and appropriate letter.

It was stated in the commentary that there are “3 important principles in relation to hypoglycemia-mediated cerebral injury in the newborn,” with the first being prolonged and severe hypoglycemia, which would not relate to a single blood glucose level of <45 mg/dL. The second principle related to the regional cerebral vulnerability and pattern of injury. The third outlined that “mild hypoglycemia combined with mild hypoxia-ischemia resulted in cerebral injury, whereas either of the 2 conditions in isolation did not.”

Thus, as indicated by the authors in their letter, the statement that brief hypoglycemia at <45 mg/dL could lead to cerebral injury in the absence of any other cerebral insult would be a misinterpretation of my commentary. There are, indeed, no data...

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