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Hyperglycemia in Extremely Preterm Infants

Sara Ramel1, Raghavendra Rao1,2

  • 1Department of Pediatrics, Division of Neonatology, University of Minnesota, Minneapolis, MN.

Neoreviews
|February 2, 2020
PubMed

Insights

Hyperglycemia in extremely preterm infants is common and linked to poor outcomes. Managing blood sugar involves balancing risks of high glucose versus hypoglycemia, necessitating further research for optimal infant care.

Area of Science:

  • Neonatalogy
  • Pediatric Endocrinology

Background:

  • Hyperglycemia is frequent in extremely preterm infants (<28 weeks gestation).
  • Risk factors include lower gestational age, birthweight, severe illness, and high parenteral glucose. Protective factors include higher amino acid/lipid intake and early enteral feeding.
  • Neonatal hyperglycemia is linked to increased mortality, morbidity, and potential long-term adverse effects on growth, neurodevelopment, and metabolic health.

Purpose of the Study:

  • To review the current understanding of hyperglycemia in extremely preterm infants.
  • To discuss the risks and benefits of current treatment strategies.
  • To highlight the need for further research.

Main Methods:

  • Literature review of studies on neonatal hyperglycemia.
  • Analysis of risk factors and outcomes.
  • Evaluation of treatment options (glucose reduction vs. insulin therapy).

Main Results:

  • Hyperglycemia is associated with significant short-term and potential long-term negative health consequences.
  • Reducing glucose infusion may cause calorie deficits, impacting growth and neurodevelopment.
  • Insulin therapy carries a risk of hypoglycemia and requires intensive monitoring.

Conclusions:

  • Current treatment options for neonatal hyperglycemia present distinct challenges and risks.
  • Further randomized trials are essential to determine optimal nutrient provision and insulin therapy strategies.
  • Improved clinical management is crucial for the long-term health of extremely preterm infants.

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