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Hyperglycemia in Extremely Preterm Infants-Insulin Treatment, Mortality and Nutrient Intakes

Itay Zamir1, Andreas Tornevi2, Thomas Abrahamsson3

  • 1Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.

The Journal of Pediatrics
|May 8, 2018
PubMed

Insights

Hyperglycemia is common in extremely preterm infants. Insulin treatment may reduce mortality in these infants, suggesting a need for reevaluation of current treatment practices in clinical trials.

Area of Science:

  • Neonatalogy
  • Endocrinology
  • Pediatric Critical Care

Background:

  • Extremely preterm infants often experience hyperglycemia.
  • Understanding the factors influencing hyperglycemia and its impact on mortality is crucial.

Purpose of the Study:

  • To determine the prevalence of hyperglycemia in extremely preterm infants.
  • To investigate associations between nutrition, hyperglycemia, insulin treatment, and mortality.

Main Methods:

  • Utilized data from the Extremely Preterm Infants in Sweden Study (EXPRESS).
  • Included 580 infants born before 27 weeks of gestation.
  • Analyzed glucose levels, nutritional intake, insulin treatment, and mortality up to 70 days.

Main Results:

  • Daily hyperglycemia prevalence reached up to 30% in the first two postnatal weeks.
  • Increased parenteral carbohydrate supply correlated with higher glucose concentrations.
  • Hyperglycemia more than doubled the 28-day mortality risk.
  • Insulin treatment in hyperglycemic infants was linked to lower mortality.

Conclusions:

  • Hyperglycemia is a frequent issue in extremely preterm infants.
  • Insulin treatment shows potential for reducing mortality in hyperglycemic infants.
  • Further randomized controlled trials are needed to assess hyperglycemia treatment strategies.
Abstract

Keywords:
neonatologynutrition

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