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Tight glycemic control with insulin in hyperglycemic preterm infants appears unsafe
Alsweiler JM. Pediatrics. 2012;doi:10.1542/peds.2011-2470.
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Preterm infants treated with tight glycemic controlled insulin experienced negative effects that suggest this form of treatment is neither safe nor effective for hypoglycemia, according to study results published online.
Jane M. Alsweiler, MBChB, PhD, of the University of Auckland, New Zealand, and colleagues studied 88 preterm infants; 43 infants were randomly assigned to tight control insulin treatment and the other 45 were in a control group that received standard treatment.
The researchers said infants in the tight control insulin group had a lower leg growth rate (P<.05), lower daily blood glucose concentrations and greater incidence of hypoglycemia. However, the infants in the tight group also had greater weight gain (P<.001) and head circumference growth (P<.0005). There was no statistically significant difference between the two groups for nutritional intake, morbidity or mortality.
“A reported association between hyperglycemia in the first 24 hours and reduced cerebral white matter volume on MRI at term suggests that preterm infants with neonatal hyperglycemia may be at increased risk of neurodevelopmental delay,” Alsweiler and colleagues wrote.
The researchers also said their data suggest that insulin infusion may not be a safe and effective treatment in hyperglycemic preterm neonates.
Disclosure: The researchers report no relevant financial disclosures.