Original articleEarly Elective Insulin Therapy Can Reduce Hyperglycemia and Increase Insulin-Like Growth Factor-I Levels in Very Low Birth Weight Infants
Section snippets
Study Design
Infants were recruited from 2 centers, the Rosie Maternity Hospital and the Luton and Dunstable Hospital NHS Trust. Inclusion criteria were birth weight <1.5 kg, age at recruitment <24 hours, and existing arterial access to allow blood sampling. An infant was excluded if the mother had any history of diabetes (prepregnancy or gestational) or if the infant had a major congenital anomaly. Of the eligible infants, approximately 55% were recruited for the study. Approximately 10% of all eligible
Results
A total of 17 infants (10 male, 7 female) with birth weight <1.5 kg and requiring intensive care were recruited within 24 hours of birth and monitored for up to 7 days. Eight infants were randomized to control, and 9 were randomized to early insulin treatment. There was 1 male infant (in the intervention arm) in whom there were significant protocol violations (treatment with sliding-scale insulin, with 20% dextrose not used according to the study protocol); thus this infant was excluded from
Discussion
The results of this pilot study confirm the high prevalence and duration of hyperglycemia during the first 7 days of life in VLBW infants requiring intensive care despite the use of standard intensive care guidelines to monitor and treat such episodes. These findings also support our hypothesis that hyperglycemia in VLBW newborns can be prevented by the early elective initiation of insulin therapy, and that continuous insulin infusions can be used without increasing the prevalence of
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Cited by (0)
The equipment required for continuous glucose monitoring was provided by Medtronic Ltd, Watford, Hertfordshire, UK.
- 1
K.B. was supported by a SPARKS Research Fellowship.
- 2
J.F. was supported by a grant from the Danish Research Council for Health and Disease.