Abstract 55

Background Persistent hyperglycemia and insulin treatment is difficult to manage in newborn infants. Counterregulatory hormones and/or insufficient beta cell activity may play a roll. Microdialysis (MD) is a novel technique that may be used to continuously monitor levels of small molecules in the adipose tissue. We have previously shown with MD that newborn infants have unstable glucose levels during the first days of life.

Subjects and materials We have studied a preterm infant (GA 26+0, BW 872 g) with persistent hyperglycemia. Insulin treatment was started at day 10. Intermittent oral feeding every 3 hour by nasogastric tube was started at day 2. Full enteral nutrition was achieved at day 10. To monitor glucose levels during insulin treatment, a MD catheter was inserted in the abdominal sc. adipose tissue at day 17. Samples were collected over 30 min and glucose analyzed enzymatically. Blood samples were only obtained when clinically indicated.

Results Due to MD monitoring of glucose levels the number of hyper/hypoglycemic incidents were decreased with 60% from day 3 to 4 in spite of the fact that insulin load was the same (0,04 IU/kg/h). There was a strong correlation between dialysate and blood glucose. Initially the infant displayed extreme unstable glucose levels. There were no complications.

Conclusions Microdialysis technique appears to be valuable in continuously monitoring of glucose metabolism during insulin treatment in newborn infants. The technique is suitable even in newborn infants below 1000 g.