Survey of the management of neonatal hyperglycaemia in Australasia

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Jane M Alsweiler1, Carl A Kuschel, Frank H Bloomfield

  • 1Newborn Services, National Women's Health, Auckland City Hospital and The Liggins Institute, University of Auckland, Auckland, New Zealand. jalsweiler@adhb.govt.nz

Journal of Paediatrics and Child Health
|July 5, 2007
PubMed

Insights

Management of neonatal hyperglycemia in very low birthweight infants varies widely across Australasia. This highlights the need for more research to establish optimal blood glucose targets and treatment protocols for these vulnerable infants.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Clinical Practice Guidelines

Background:

  • Neonatal hyperglycemia is prevalent in very low birthweight (VLBW) preterm infants.
  • Hyperglycemia is linked to increased intraventricular hemorrhage and mortality in VLBW neonates.
  • Current clinical guidelines for managing neonatal hyperglycemia are limited.

Purpose of the Study:

  • To survey Australasian tertiary neonatal intensive care units regarding their practices for defining and managing neonatal hyperglycemia.
  • To gather data to inform the design of a randomized controlled trial on tight glycemic control in VLBW infants.

Main Methods:

  • An online survey was distributed to 27 tertiary neonatal units in Australasia.
  • The survey collected information on unit-specific definitions and management strategies for hyperglycemia in VLBW infants.

Main Results:

  • Twenty-three units responded, revealing six different definitions of hyperglycemia.
  • Most units defined hyperglycemia as blood glucose >10 mM.
  • Significant variation existed in insulin initiation criteria (8-15 mM +/- glycosuria) and target blood glucose ranges (2.5-8 mM to 8-15 mM).

Conclusions:

  • There is substantial heterogeneity in the management of neonatal hyperglycemia across Australasian tertiary units.
  • This variation underscores the lack of robust data guiding clinical practice.
  • Further research is essential to establish evidence-based guidelines for neonatal hyperglycemia management.
Abstract

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