Hyperglycemia in newborns is most common in premature infants. At present, in clinical practice, the attitude towards this type of metabolic disorders is not well defined and controversial.
Objective: To determine the feasibility of prescribing insulin for hyperglycemia in premature newborns.
Patients and Methods: We observed 68 newborns with a birth weight of 1326 ± 119.8 g and a gestational age of 29 ± 1.1 weeks. In the early neonatal period, hyperglycemia was observed in all children (9.3 - 10.2 mmol / l; glycosuria - 0.5%).
Determination of glucose in the blood was carried out by the method of Glucose oxidase.
Results: All children had such problems with adaptation as respiratory distress syndrome and cerebral pathology. 45 children received insulin injections. 23 children did not receive insulin treatment. None of the newborns had symptoms of hypoglycemia. In the insulin group, the caloric value increased from 38 ± 30 to 68 ± 19 kcal / kg / day. In the group where the newborns did not receive any treatment with insulin, the caloric value was 39 ± 21 kcal / kg / day. It took the insulin group 10 ± 5 days to reach normal body weight at birth. While the group that did not receive insulin treatment, it took 11 ± 6 days. At the end of the neonatal period, hyperglycemia disappeared. But in 16 children (9 from the insulin group and 7 from the other group), intraventricular hemorrhage was noted with degrees II and III. All newborns were transferred to spontaneous breathing at 10 ± 5 days after birth. Thus, we found no evidence of differences in the observed groups.
Conclusions: In preterm infants with very low birth weight, hyperglycemia can be considered a transitional state. The appointment of insulin inappropriate.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology