Hyperglycemia and Retinopathy of Prematurity in Very Low Birth Weight Infants

Garg, Ruchira; Agthe, Alexander G; Donohue, Pamela; Lehmann, Christoph U.

doi:10.1038/sj.jp.7210879

Cited by 139 publications

(121 citation statements)

References 54 publications

(41 reference statements)

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…20 Adverse outcomes such as increased severity of ROP have been linked with high glucose levels in ELBW infants. 1,9,10 However, the infants in these studies also had a high severity of illness, making the results difficult to interpret. In this study, using our novel approach to analyze glucose data (TWGL) as a proxy for continuous glucose monitoring, we determined that in ELBW infants glucose levels currently considered within the normal range are linked to the development of severe ROP after correcting for the most significant demographic, perinatal and clinical factors.…”

Section: Abnormal Glucose Levels In Elbw Infantsmentioning

confidence: 75%

“…8 Recently, high glucose levels have been associated with an increased ROP incidence in ELBW infants. 1,9,10 However, there is no evidence demonstrating a direct cause-effect relationship. The lack of an accepted severity of illness score for newborns after the first 24 h of life 11 complicates interpretation of the data, as glucose instability can be an expression of severity of illness, 12,13 which may be the risk factor for ROP.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Contribution of early glycemic status in the development of severe retinopathy of prematurity in a cohort of ELBW infants

et al. 2011

View full text Add to dashboard Cite

Objective: The objective of this study is to investigate the relationship between glycemic status and severe retinopathy of prematurity (ROP).Study Design: This is a retrospective cohort study of 114 infants <1000 g admitted to a level IV neonatal intensive care unit within 48 h of life. A cumulative, time-weighted glucose level (TWGL) derived from plotting glucose values over time was included in logistic regression analysis to identify predictors for severe ROP.Result: Infants had 26.6 ± 2 weeks gestational age and had a birth weight of 782±136 g. TWGL during first 10 and 30 days of life were greater in the severe ROP group (P<0.01). Unlike single events of glucose levels X150 mg dl À1 , 10 days TWGL X100 mg dl À1 (odds ratio (OR) 5.2, P<0.02) and 30 days TWGL X118 mg dl À1 (OR 5.7, P<0.02) were predictors for severe ROP (univariate). Multivariate regression confirmed 30 days TWGL X118 mg dl À1 (OR 9.4 to 10) and gram-positive sepsis (OR 4.1 to 5) as predictors for severe ROP (P<0.05). Conclusion:High overall glycemic status is associated with the development of severe ROP.

show abstract

Section: Abnormal Glucose Levels In Elbw Infantsmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 98%

Contribution of early glycemic status in the development of severe retinopathy of prematurity in a cohort of ELBW infants

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Elevated blood glucose levels (BG) (Hyperglycaemia) is a common complication of prematurity and stress in neonatal intensive care, and while definitions and thresholds vary [11], studies show that 30-70% of very/extremely low birth weight infants have at least one BG> 8 mmol/L [12][13][14][15][16]. Hyperglycaemia is associated with increased mortality [15][16][17], and morbidity/complications in this cohort [15][16][17][18][19][20][21], but there is still debate over whether hyperglycaemia causes increased morbidity, or is reflective of worsened condition.…”

Section: Introductionmentioning

confidence: 97%

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

Dickson

Pretty

Alsweiler

et al. 2017

Mathematical Biosciences

View full text Add to dashboard Cite

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.

show abstract

“…Hyperglycaemia has been linked to worsened outcomes. Associated morbidities include osmotic diuresis, electrolyte imbalance, intraventricular haemorrhage, sepsis, and increased ventilator dependence, retinopathy of prematurity, hospital length of stay and mortality [2][3][4][5][7][8][9]. High rates of proteolysis are also common in low birth weight infants, reducing muscle mass and inhibiting growth [10].…”

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

View full text Add to dashboard Cite

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

show abstract

Hyperglycemia and Retinopathy of Prematurity in Very Low Birth Weight Infants

Abstract: In this study, we could demonstrate that glucose levels in the first month of life are associated with the development of ROP. Further studies have to determine if this association is causal or if hyperglycemia is just an expression of severity of illness.

Cited by 139 publications

References 54 publications

Contribution of early glycemic status in the development of severe retinopathy of prematurity in a cohort of ELBW infants

Contribution of early glycemic status in the development of severe retinopathy of prematurity in a cohort of ELBW infants

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

Development of blood glucose control for extremely premature infants

Contact Info

Product

Resources

About