To investigate the success rate of intramuscular (IM) glucagon in preventing need for IV glucose and describe its glycemic effect.
Retrospective study of 158 consecutive term neonates with feeding-resistant hypoglycemia treated with glucagon.
After glucagon, blood glucose (BG) increased in all but 1 infant by 25.9 ± 17.1, 42.1 ± 21.1, and 39.2 ± 28.3 mg/dL (1.4 ± 0.9, 2.3 ± 1.2, 2.2 ± 1.6 mmol/L) at 30, 60 and 120 mins respectively. In multivariable logistic regression, glucagon success was dependent upon gender (increased male risk) (P = 0.021), meeting American Academy of Pediatrics (AAP) criteria for immediate IV glucose (P = 0.004), birth weight, (P = 0.018) and delta glucose concentration at 60 min (P = 0.013). After IM glucagon, 24 out of 49 infants that met AAP criteria for immediate IV glucose (49%) ended up not requiring any additional intervention.
Glucagon increases BG nearly universally in hypoglycemic infants and allowed reducing the number of infants that needed immediate IV glucose infusion therapy by ≈half.
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The authors declare that they have no conflict of interest.
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Ophir Dotan’s participation in this study was performed in fulfillment of research requirements toward the MD degree.
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Kasirer, Y., Dotan, O., Mimouni, F.B. et al. The use of intramuscular glucagon to prevent IV glucose infusion in early neonatal hypoglycemia. J Perinatol 41, 1158–1165 (2021). https://doi.org/10.1038/s41372-021-00925-x