Abstract
The frequency of glucose intolerance (blood glucose or Dextrostix®≥130mg% for ≥12 hours accompanied by glucosuria ≥ tr) was determined in 30 consecutively born VLBW infants who weighed ≥1250g; lived for more than 48 hours; and received intravenous (IV) glucose (glu). The majority, 87% (26/30), survived.
Twenty episodes of glucose intolerance occurred in 14 (47%) of the infants. Day of onset varied widely (x=8, range 0-25) as did duration (x=4, range 0.5-9.0). Intolerant infants were smaller (0.98 vs 1.10kg p<.01); more premature (28.5 vs 30.2 weeks gestation, p<.01); more often had respiratory failure (90 vs 50%) and hyperglycemia (62 vs 33%) within the first 24 hours; and were fed orally later (da 13 vs da 5, p<.001) than infants who did not become intolerant.
Clinical events known to be associated with hyperglycemia preceded 1/3 of the episodes. The remainder were associated only with an increase (x=0.2g/kg/h) in IV glu infusion rate. Only 3 episodes resolved without reducing the IV glu load. Eleven episodes (55%) required a decrease (x=0.5g/kg/h) in glu infusion rates to less than that (x=-0.3g/kg/h) tolerated prior to hyperglycemia and resulted in a 40% decrease in caloric intake.
These data suggest that glucose intolerance, a common problem in the nutritional management of VLBW infants, is usually due to an increase in IV glu load alone; that early oral feeding may reduce the risk of occurrence; and that glu tolerance frequently deteriorates following persistent hyperglycemia and glucosuria.
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Vaucher, Y., Morrow, G. 1034 GLUCOSE INTOLERANCE IN VERY LOW BIRTHWEIGHT (VLBW) INFANTS. Pediatr Res 12 (Suppl 4), 536 (1978). https://doi.org/10.1203/00006450-197804001-01040
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DOI: https://doi.org/10.1203/00006450-197804001-01040