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Effect of enteral administration of insulin on intestinal development and feeding tolerance in preterm infants: a
1USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, and Texas Children's Hospital, Houston, Texas, USA. rshulman@bcm.tmc.edu
Insights
Enteral insulin administration in preterm infants (26-29 weeks gestational age) enhanced gastrointestinal development and reduced feed intolerance without adverse effects. Further randomized trials are recommended to confirm these promising findings for infant nutrition.
Area of Science:
- Neonatal medicine
- Gastroenterology
- Pediatric nutrition
Background:
- Preterm infants (26-29 weeks gestational age) often experience gastrointestinal (GI) immaturity and feed intolerance.
- Enhancing GI development and reducing feeding issues are critical for improving outcomes in this vulnerable population.
Purpose of the Study:
- To pilot the enteral administration of insulin in preterm infants.
- To assess the effects of enteral insulin on GI development and feed intolerance.
- To evaluate the safety of enteral insulin in this population.
Main Methods:
- Eight preterm infants received 4 U/kg/day of enteral insulin from 4 to 28 days of age.
- Lactase activity was measured at 28 days; feed intolerance was monitored throughout hospitalization.
- Results were compared to a historical cohort of 80 preterm infants.
Main Results:
- No adverse events, including hypoglycemia, were observed.
- Infants receiving enteral insulin demonstrated higher lactase activity.
- Enteral insulin group showed reduced feed intolerance, including a 30% shorter time to full enteral feeds and fewer gastric residuals.
Conclusions:
- Preliminary data suggest enteral insulin may benefit preterm infants by reducing feed intolerance.
- Enteral insulin appears safe and potentially enhances GI development.
- A randomized, blinded trial is warranted to confirm these findings.
Objective:
To determine in a pilot study whether enteral administration of insulin to preterm infants (26-29 weeks of gestational age) would enhance gastrointestinal development and reduce feed intolerance without adverse effects.
Design:
Eight preterm infants were given 4 U/kg/day insulin enterally from 4 to 28 days of age. Lactase activity was measured at 28 days of age, while measures of feed intolerance were made throughout the hospital stay. The results were compared with those of a matched historical cohort of 80 preterm infants.
Setting:
Tertiary care, university affiliated hospital.
Main Outcome Measures:
Lactase activity and feed intolerance.
Results:
No adverse effects, such as hypoglycaemia, were observed after administration of insulin. The infants who received insulin had higher lactase activity and less feed intolerance than the controls (30% shorter time to full enteral feeds; fewer gastric residuals per infant).
Conclusion:
These preliminary data suggest that enteral insulin administration may be of benefit in reducing feed intolerance in preterm infants. A randomised, blinded trial is warranted.
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