Glucose Homeostasis in the Micropremie

Farrag, H.; Cowett, Richard M.

doi:10.1016/s0095-5108(05)70004-x

Cited by 64 publications

(53 citation statements)

References 66 publications

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“…Most studies to date have linked hyperglycemia with short-term outcomes such as sepsis, glucosuria, osmotic diuresis and dehydration. 1,3,4,9 Therefore, the aim of this study was to evaluate the incidence of hyperglycemia in ELBW infants, correlates and associated morbidities.…”

Section: Discussionmentioning

confidence: 99%

“…4,9,13 Measurements of glucose levels were performed using the glucose oxidation technique (AU 640 Immuno Analyzer, Olympus Inc., Center Valley, PA, USA) at a frequency determined by the clinical status of each infant. The highest glucose value per day was recorded in all infants (G peak ).…”

Section: Data Collectionmentioning

confidence: 99%

“…[1][2][3] Many of these infants have glucose intolerance resulting in hyperglycemia, a condition that has become increasingly important with reports of up to 68% of ELBW infants during the first few weeks of life. 4 In fact, the neonate with BW less than 1100 g is 18 times more likely to develop hyperglycemia than one who weighs more than 2000 g. 5 Several conditions have been implicated in the development of neonatal hyperglycemia, including intravenous fluids, parenteral nutrition, stress and drug treatment, in particular steroids. [6][7][8][9][10] Some investigators have evaluated the short-term adverse effects of hyperglycemia in the neonate; 1,11 however, few have focused on long-term outcomes such as intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP) and death.…”

Section: Introductionmentioning

confidence: 99%

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Hyperglycemia in extremely low birth weight infants in a predominantly Hispanic population and related morbidities

et al. 2006

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Objective: This study describes the incidence, correlates and subsequent morbidities of hyperglycemia, a highly prevalent condition in extremely low birth weight (ELBW) infants.Study design: A retrospective chart review of 169 infants with birth weight (BW)<1000 g was conducted. Hyperglycemia was defined as plasma glucose level X150 mg/dl during the first 2 weeks of life. Data were analyzed by logistic regression, multivariate analysis and Fisher exact test.Results: Overall, 88% of the study sample developed hyperglycemia in the first 2 weeks of life. Both gestational age (GA) (odds ratio (OR) 0.11, 95% confidence interval (CI) ¼ 0.01-0.89) and chorioamnionitis (OR 0.10, 95% CI ¼ 0.01-0.64) were inversely associated with hyperglycemia, whereas BW, sepsis and postnatal steroid exposure were not. After adjusting for GA, BW and postnatal steroids, hyperglycemia was associated with a statistically significant increase in retinopathy of prematurity (ROP) (OR 4.6, 95% CI 1.12-18.9). No association was found with bronchopulmonary dysplasia, intraventricular hemorrhage, death or prolonged hospital stay. Conclusion:Lower GA was identified as the main factor associated with hyperglycemia in ELBW infants during the first 2 weeks of life. Hyperglycemia was associated with an increased incidence of ROP; further studies need to determine if this association is causal.

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Section: Discussionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hyperglycemia in extremely low birth weight infants in a predominantly Hispanic population and related morbidities

et al. 2006

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“…In adult intensive care even a single hypoglycaemic episode has been associated with increased risk of mortality [31][32][33], while in neonatal intensive care hypoglycaemia as been associated with adverse neurological outcomes [34,35]. Model-based methods for glycaemic control have been little investigated, due in part to the extremely fragile nature of this cohort and the subsequent limitations on invasive procedures and blood sample collection [36] that thus also limit the ability to identify parameters to validate more physiologically relevant and complex models.…”

Section: Introductionmentioning

confidence: 99%

Insulin kinetics and the Neonatal Intensive Care Insulin–Nutrition–Glucose (NICING) model

Dickson

Pretty

Alsweiler

et al. 2017

Mathematical Biosciences

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Background: Models of human glucose-insulin physiology have been developed for a range of uses, with similarly different levels of complexity and accuracy. STAR (Stochastic Targeted) is a modelbased approach to glycaemic control. Elevated blood glucose concentrations (hyperglycaemia) are a common complication of stress and prematurity in very premature infants, and have been associated with worsened outcomes and higher mortality. This research identifies and validates the model parameters for model-based glycaemic control in neonatal intensive care.

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“…In addition to these factors, it has been shown that preterm infants can mount a hormonal response to stress similar to older critically ill patients [15]. Inhibiting the physiological response to reduce increased glycaemic levels are factors such as increased insulin resistance, absolute or relative insulin deficiency, and drug therapy [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Development of blood glucose control for extremely premature infants

Compte

Chase

Lynn

et al. 2011

Computer Methods and Programs in Biomedicine

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Abstract:Extremely premature neonates often experience hyperglycaemia, which has been linked to increased mortality and worsened outcomes. Insulin therapy can assist in controlling blood glucose levels and promoting needed growth. This study presents the development of a model-based stochastic targeted controller designed to adapt insulin infusion rates to match the unique and changing metabolic state and control parameters of the neonate. Long-term usage of targeted BG control requires successfully forecasting variations in neonatal metabolic state, accounting for differences in clinical practices between units, and demonstrating robustness to errors that can occur in everyday clinical usage. Simulation studies were used to evaluate controller ability to target several common BG ranges and evaluate controller sensitivity to missed BG measurements and delays in control interventions on a virtual patient cohort of 25 infants developed from retrospective data. Initial clinical pilot trials indicated model performance matched expected performance from simulations. Stochastic targeted glucose control developed using validated patient-specific virtual trials can yield effective protocols for this cohort. Long-term trials show fundamental success, however clinical interface design appears as a critical factor to ensuring good compliance and thus good control.3

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Glucose Homeostasis in the Micropremie

Cited by 64 publications

References 66 publications

Hyperglycemia in extremely low birth weight infants in a predominantly Hispanic population and related morbidities

Hyperglycemia in extremely low birth weight infants in a predominantly Hispanic population and related morbidities

Insulin kinetics and the Neonatal Intensive Care Insulin–Nutrition–Glucose (NICING) model

Development of blood glucose control for extremely premature infants

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