Abstract
BACKGROUND: Glucose values <2.7 mmol/l >48h or on >5 occasions lead to neurological deficits. Bedside glucose measurement devices are inaccurate. AIM: To determine whether frequent random blood sugar (BS) measurements in infants <31 weeks and 1000g are helpful in detecting hypoglycaemias.
METHODS: Retrospective data analysis of 10 inborn infants <31 weeks and <1000g. Exclusions: gestational diabetes, maternal diabetogenic medication, SGA, LGA, hypothermia, inotropes and polycythaemia. Statistical analysis with EXCEL und SPSS.
RESULTS: GA was 29 weeks (range 26–30) and birthweight 915g (range 750–950). 80% presented a BS >2.0mmol/l at 1h (range 0.25–1.5) after birth. During the first 10 days of life BS were 6mmol/l (range 4–9) and 5mmol/l (range 4–7) until discharge. During the first 10 days of life BS were measured 23 times (range 11–51) and 42 times (range 11–110) until discharge. Carbohydrate intake and BS correlated significantly (r = 0,37, p = 0,031), whereas protein or lipid intake and BS did not. There was no significant correlation between frequency of BS monitoring and the number of recorded hypoglycaemias (r = 0,48, p = 0,082). The lowest BS measured per patient was 2.2mmol/l (range 1.2–4.2). This happened mainly on day 1 (range 1–34). 90% were asymptomatic. Only 20% had appropriate nutritional intake during hypoglycaemia. In 50% a glucose infusion (10%) at 60 ml/kg/d was started, 2 had a glucose bolus of 200 mg/kg i.v., 3 did not have treatment.
CONCLUSIONS: Hypoglycaemia in infants <31 weeks and <1000g is rare. They happen mainly at admission on day 1 and are mainly asymptomatic. BS should be >2.0 mmol/l 1h after birth. A continuous carbohydrate intake of 13g/kg/d is sufficient to maintain BS at 5–6 mmol/l. Frequent random BS measurements are not helpful in detecting asymptomatic hypoglycaemias in preterm infants <1000g.
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Fernandez Alvarez, J., Graham-Evans, K., Smyth, J. et al. 115 Blood Sugar Monitoring in Preterm Infants < 31 Weeks and < 1000 G. Pediatr Res 58, 374 (2005). https://doi.org/10.1203/00006450-200508000-00144
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DOI: https://doi.org/10.1203/00006450-200508000-00144