A comparison of the glycemic effects of glucagon using two dose ranges in neonates and infants with hypoglycemia

Abstract

Introduction

Consensus regarding optimal glucagon dosing for management or diagnosis of neonatal/infant hypoglycemia has not been established.

Objective

To investigate glycemic effects of glucagon dosed ≤0.2 mg/kg (Gnlow) vs. >0.2 mg/kg (Gnhigh) in neonatal/infant hypoglycemia.

Study design

Retrospective, observational, cohort study.

Results

Glucagon administration at any dose resulted in 75/77 (97.4%) samples meeting criteria for normoglycemia (plasma glucose >60 mg/dL), and plasma glucose increases of >30 mg/dL occurred in 74.2% vs. 63% (NS) of samples in the Gnlow and Gnhigh groups, respectively. Despite equivalent glucagon dosing, there was a trend toward smaller (<2500 g) patients achieving post-glucagon plasma glucose increases of >30 mg/dL less often than their bigger (≥2500 g) counterparts (60% vs. 74.1%, NS).

Conclusions

Glucagon is highly effective in raising plasma glucose levels in neonatal/infant hypoglycemia. No differences in glycemic effects were noted between either dosing regimen. However, glycemic effects may be diminished in lower weight patients.

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Fig. 1: Patient selection flow diagram.

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Funding

The project was funded with no specific support

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R.G. collected and analyzed the data, drafted the initial manuscript, and approved the final manuscript. M.T. analyzed the data, revised the manuscript, and approved the final manuscript. D.J.K. analyzed the data, drafted the initial manuscript, and approved the final manuscript.

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Correspondence to Doron J. Kahn.

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Godin, R., Taboada, M. & Kahn, D.J. A comparison of the glycemic effects of glucagon using two dose ranges in neonates and infants with hypoglycemia. J Perinatol 40, 1841–1848 (2020). https://doi.org/10.1038/s41372-020-00770-4

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