Dextrose gel effective treatment for hypoglycemia

Dextrose gel can be used as a first-line treatment for late preterm and term babies with hypoglycemia within 48 hours of birth, according to recent study findings published in The Lancet.

“Our study is the first report in babies showing that dextrose gel massaged into the inside of the cheek is more effective than feeding alone for treating hypoglycemia, and is safe and simple to use,” Jane E. Harding, FRACP, of the University of Auckland in New Zealand, said in a press release. “Dextrose gel treatment costs roughly $2 per baby and could help reduce admissions to neonatal intensive care for treatment with intravenous glucose — not only reducing costs but importantly, keeping mothers and babies together to encourage breast-feeding.”

The randomized, double blind, placebo-controlled trial included 237 babies aged 32 to 42 weeks gestation, but younger than 48 hours, who became hypoglycemic and placed into either the dextrose group (n=118) or the placebo group (n=119).

Overall, treatment failure frequency was decreased by dextrose gel compared with the placebo group (RR=0.57; 95% CI, 0.33-0.98). Participants at aged 2 weeks were less likely to be formula-fed if they were in the dextrose group compared with the placebo group (RR=0.34; 95% CI, 0.13-0.9).

“Because this treatment is inexpensive and simple to administer, it should be considered for first-line management of late preterm and term hypoglycemic babies in the first 48 hours after birth. ... [Dextrose gel] can easily be made in the hospital pharmacy, and is stable at room temperature,” Harding said. “Therefore, the gel could also be useful in resource-poor settings where hypoglycemia is common and under diagnosed.”

In an accompanying editorial, Neil Marlow, FRCP, FRCPH, of the University College of London Institute for Women’s Health, wrote that although the results of the trial show the efficacy of glucose better information needs to be gathered at which levels blood glucose should be used. “Such trials can and should be randomized and include outcome evaluations to strengthen our understanding of the association between low blood glucose readings, their time course, and neurological outcomes. ... Until more information is available, practice will continue to be based on uncertain facts; however, use of buccal dextrose gel should help to minimize unnecessary interventions,” Marlow wrote.

For more information:

Harris DL. Lancet. 2013;doi:10.1016/S0410-6736(13)61645-1.

Marlow N. Lancet. 2013;doi:10.1016/S0140-6736(13)61755-9.

Disclosure: See study for a full list of disclosures.