Risk Factors for Neonatal Hyperglycemia Associated With 10% Dextrose Infusion

Blood-Biomarkers for Glucose Metabolism in Preterm Infants

“…We found that the glucose levels were generally higher in all the "ill" preterm subgroups, especially during the early postconceptional period. Similarily, several previous studies found that hyperglycemia was especially pronounced during the early postconceptional period [3,8,11,12,24,25]. As was previously described, we found a clear association between prolonged hyperglycemia and increased occurrence of neonatal morbidity (such as IVH, NEC, ROP) [8,[10][11][12]26].…”

“…Based on clinical conditions known to influence glucose metabolism, the study cohort was divided into a “healthy” (reference) group and four “ill” subgroups related to degree of prematurity and presence of SGA [ 3 , 5 , 8 , 10 , 11 , 12 , 24 ]. Defining a “heathy” reference group is a novel apporach.…”

“…We speculate whether the total body protein pool in these “ill” preterm infants was depleted, which could also prohibit optimal postnatal growth [ 32 , 33 ]. In fact, we did find that the “ill” infants had suboptimal postnatal growth compared to “healthy” infants [ 3 , 5 , 8 , 10 , 11 , 12 , 24 ]. In addition, growth restriction was more pronounced in “ill” infants born extremely premature or SGA, and was also consistent with decreased protein-containing biomarker levels [ 4 ].…”

Dextrose boluses versus burette dextrose infusions in prevention of hypoglycemia among preterms admitted at Mulago Hospital: an open label randomized clinical trial.

“…Most of the preterms who developed hyperglycemia in the infusion arm were found to have a faster infusion rate (drops/min) than previously set. This is comparable to Louik Carol et al in Boston who described hyperglycemia to occur among infants receiving 10% dextrose infusion and its risk increased with increasing dextrose dose as well as decreasing birth weight and gestational age (14) . This study was not powered to explore hyperglycemia and risk factors among preterms.…”

Insulin for Treatment of Neonatal Hyperglycemia in Premature Infants: Prevalence over Time and Association with Outcomes

“…Infants treated with 7 insulin had lower GA, lower BW, lower 5-minute Apgar scores, longer duration of stay in the NICU, and were more likely to receive mechanical ventilation. These conditions are also risk factors for other conditions that contribute to hyperglycemia, such as sepsis, longer duration of parenteral nutrition, or receipt of medications, such as steroids, and vasoactive agents [4,15,17,18,31]. We also evaluated adverse outcomes among infants with differing durations of insulin treatment, though we were unable to distinguish whether the adverse outcomes were due to hyperglycemia or insulin therapy.…”