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Neonatal hyperglycaemia increases mortality and morbidity in preterm lambs
Jane M Alsweiler1, Jane E Harding, Frank H Bloomfield
1Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand. j.alsweiler@auckland.ac.nz
Neonatology
|November 7, 2012
Summary
Neonatal hyperglycaemia in preterm lambs significantly increases mortality and morbidity, while decreasing growth. Insulin treatment improved outcomes but did not fully restore growth, highlighting the complex effects of blood glucose regulation in premature neonates.
Area of Science:
- Neonatal physiology
- Endocrinology
- Perinatal medicine
Background:
- Hyperglycaemia in preterm infants is associated with increased mortality and morbidity.
- The causal relationship and the efficacy of insulin treatment remain unclear.
Purpose of the Study:
- To investigate the impact of neonatal hyperglycaemia on mortality and morbidity in preterm lambs.
- To determine if insulin treatment improves outcomes in hyperglycaemic preterm lambs.
Main Methods:
- Preterm lambs were randomized into groups receiving saline, dextrose (to induce hyperglycaemia), or dextrose with insulin.
- Infusions were titrated to maintain specific blood glucose concentrations.
- Outcomes measured included mortality, fever incidence, and weight gain over 12 days.
Main Results:
- Hyperglycaemic lambs exhibited significantly higher mortality rates (23%) compared to controls (5%).
- The hyperglycaemic group also showed a higher incidence of fever (55%) and reduced weight gain.
- Insulin treatment normalized blood glucose levels, reduced mortality, and decreased fever incidence, but did not improve weight gain.
Conclusions:
- Neonatal hyperglycaemia in preterm lambs is a direct cause of increased mortality, morbidity, and impaired growth.
- Insulin therapy can mitigate the adverse effects on mortality and morbidity but does not fully reverse growth deficits.
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