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Dextrose Gel for Neonates at Risk With Asymptomatic Hypoglycemia: A Randomized Clinical Trial

Kirti Gupta, Prakash Amboiram, Umamaheswari Balakrishnan

    Pediatrics
    |May 18, 2022
    PubMed

    Insights

    Dextrose gel effectively treats asymptomatic hypoglycemia in newborns, significantly reducing the need for intravenous fluids and preventing hospital admissions. This intervention supports breastfeeding and minimizes mother-infant separation.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Endocrinology

    Background:

    • Neonatal hypoglycemia affects 5-15% of newborns, often necessitating intravenous fluid treatment.
    • Intravenous fluids can lead to hospital admission and separation of mother and infant.
    • Dextrose gel presents a potential non-invasive alternative to reduce these interventions.

    Purpose of the Study:

    • To evaluate the efficacy of dextrose gel in preventing the need for intravenous fluids in at-risk neonates with asymptomatic hypoglycemia.
    • To assess the impact of dextrose gel on treatment failure rates across different at-risk infant categories.

    Main Methods:

    • A stratified randomized controlled trial was conducted on at-risk infants presenting with asymptomatic hypoglycemia.
    • Infants were categorized into: small for gestational age/intrauterine growth-restriction (SGA/IUGR), infants of diabetic mothers/large for gestational age (IDM/LGA), and late preterm (LPT) neonates.
    • The intervention group received dextrose gel and breastfeeding, while the control group received only breastfeeding.

    Main Results:

    • Out of 629 infants, 291 (46%) had asymptomatic hypoglycemia. Treatment failure occurred in 11.5% of the dextrose gel group versus 40.2% in the control group (Risk Ratio: 0.28).
    • Significantly lower treatment failure rates were observed in the dextrose gel group across all stratified categories: SGA/IUGR (RR: 0.29), IDM/LGA (RR: 0.31), and LPT (RR: 0.24).

    Conclusions:

    • Dextrose gel is an effective intervention for managing asymptomatic hypoglycemia in neonates.
    • The use of dextrose gel significantly reduces the requirement for intravenous fluid therapy in at-risk newborns within the first 48 hours of life.
    • This approach can help avoid hospital admissions and maintain mother-infant bonding.
    Abstract

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