Original ArticleOutcome at 2 Years after Dextrose Gel Treatment for Neonatal Hypoglycemia: Follow-Up of a Randomized Trial
Section snippets
Methods
The Sugar Babies Study was a randomized, double-blind, placebo-controlled trial performed at a tertiary referral center (Waikato Women's Hospital) in Hamilton, New Zealand (Australian New Zealand Clinical Trials Registry: ACTRN 12608000623392) between December 1, 2008, and November 26, 2010, and has been reported previously.11 In brief, eligible babies were ≥35 weeks' gestation, <48 hours old, and at risk for neonatal hypoglycemia (infant of mothers with diabetes, late preterm [35 or 36 weeks'
Results
Of the 237 eligible babies, 184 (78%) were assessed at 2 years of age between July 21, 2010 and January 30, 2013 (Figure; available at www.jpeds.com). The characteristics of the mothers of children who were and were not followed up were similar, except for greater parity in mothers of those who were followed up (Table I). The characteristics of children who were and were not assessed at 2 years of age also were similar, as were those of assessed children who were randomized to dextrose gel and
Discussion
Dextrose gel is attractive as a primary treatment for neonatal hypoglycemia because it is simple, inexpensive, and with no adverse effects detected in the neonatal period.11 This follow-up study provides evidence that treatment with dextrose gel is not associated with adverse effects at 2 years' corrected age. These findings are consistent across assessment of a broad range of functions including neurodevelopment, executive function, vision and growth.
The major reason for treating neonatal
References (38)
- et al.
Knowledge gaps and research needs for understanding and treating neonatal hypoglycemia: workshop report from Eunice Kennedy Shriver National Institute of Child Health and Human Development
J Pediatr
(2009) - et al.
National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications
Lancet
(2012) - et al.
Incidence of neonatal hypoglycemia in babies identified as at risk
J Pediatr
(2012) - et al.
Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial
Lancet
(2013) - et al.
Use of dextrose gel reverses neonatal hypoglycaemia and decreases admissions to the NICU
J Obstet Gynecol Neonatal Nurs
(2015) - et al.
Relationship between test scores using the second and third editions of the Bayley Scales in extremely preterm children
J Pediatr
(2012) - et al.
Hypoglycemic brain injury
Semin Neonatol
(2001) - et al.
The activity in human areas V1/V2, V3, and V5 during the perception of coherent and incoherent motion
Neuroimage
(1997) - et al.
Brain imaging of the central executive component of working memory
Neurosci Biobehav Rev
(2002) - et al.
Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia
Pediatrics
(2008)
Neonatal morbidities and developmental delay in moderately preterm-born children
Pediatrics
Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia
BMJ
Occipital lobe injury and cortical visual outcomes after neonatal hypoglycemia
Pediatrics
Long term neurological dysfunction and neonatal hypoglycaemia after diabetic pregnancy
Arch Dis Child Fetal Neonatal Ed
Global prevalence of diabetes: estimates for the year 2000 and projections for 2030
Diabetes Care
A survey of the management of neonatal hypoglycaemia within the Australian and New Zealand Neonatal Network
J Paediatr Child Health
Implementation of dextrose gel in neonatal hypoglycaemia management
J Paediatr Child Health
Bayley scales of infant and toddler development
Executive function and theory of mind: stability and prediction from ages 2 to 3
Dev Psychol
Cited by (82)
Mise à jour technique n<sup>o</sup> 439: Corticothérapie prénatale en période de prématurité tardive
2023, Journal of Obstetrics and Gynaecology CanadaTechnical Update No. 439: Antenatal Corticosteroids at Late Preterm Gestation
2023, Journal of Obstetrics and Gynaecology CanadaLatency of late preterm steroid administration to delivery and risk of neonatal hypoglycemia
2022, American Journal of Obstetrics and Gynecology MFMCerebral Effects of Neonatal Dysglycemia
2022, Clinics in PerinatologyCitation Excerpt :Dextrose gel application reduces the need for intravenous dextrose infusion and improves success with breastfeeding.142,143 It does not improve neurosensory outcome at 2 years of age.136,144 Preventive application of dextrose gel reduces the risk of hypoglycemia and potentially major neurologic disability at 2 years of age in at-risk infants.145
How Much Glucose Is in the Gel Used to Treat Neonatal Hypoglycemia?
2022, JOGNN - Journal of Obstetric, Gynecologic, and Neonatal NursingThe Term Newborn: Hypoglycemia
2021, Clinics in PerinatologyCitation Excerpt :The increase in glucose levels is higher after the infant is fed formula than after other feedings, but breastfeeding is associated with reduced requirement for repeat gel treatment.27 At 2-year follow-up, no differences in neurosensory function have been detected between the dextrose gel and placebo groups.46 More studies using CGM and long-term follow-up will be needed to determine if dextrose gel is similar to IV dextrose boluses in raising glucose concentrations too quickly and causing highly variable values, conditions which have been associated with neurosensory impairment.24
The Sugar Babies Study was funded by the Waikato Medical Research Foundation (171), the Auckland Medical Research Foundation (1110009), the Maurice and Phyllis Paykel Trust, the Health Research Council of New Zealand (09/095), and the Rebecca Roberts Scholarship. The Follow-up Study was funded by the Health Research Council of New Zealand (10/399) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (R01HD0692201). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding bodies. The authors declare no conflicts of interest.
- ∗
List of CHYLD Study Team members is available at www.jpeds.com (Appendix).