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Dextrose gel 'a more effective treatment for hypoglycaemia in babies'

Newborn babies with hypoglycaemia should be treated with dextrose gel, according to new research published in The Lancet .

Dextrose gel also has the advantages of being cheap and easy to apply, scientists said.

Neonatal hypoglycaemia, or low blood sugar in newborns, is said to affect up to 15% of otherwise healthy babies and is a preventable cause of brain damage.

It is already used to reverse hypoglycaemia in adults with diabetes, but few studies have assessed its use in babies.

The current treatment for late pre-term and term babies involves extra feeding and repeated blood tests to measure blood sugar levels, but many babies end up in intensive care and being given intravenous glucose because their blood sugar levels do not increase.

Study leader Professor Jane Harding, from the University of Auckland in New Zealand, said: “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 breastfeeding.”

The researchers set out to discover whether treatment with dextrose gel was more effective than feeding alone at reversing hypoglycaemia in babies deemed to be at risk, such as in cases of maternal diabetes, premature birth or low birth weight.

They reported that the likelihood of treatment failure - defined as a blood glucose concentration of less than 2.6 mmol/L 30 min after the second of two doses of gel - was cut almost by half compared with placebo, and there were no adverse effects.

There was also a reduced likelihood of the babies being admitted to intensive care for hypoglycaemia, to receive additional formula feeds or to be formula fed at two weeks, the Sugar Babies study found.

Professor Harding argues the simplicity of the treatment and its minimal cost mean “it should be considered for first-line management of late pre-term and term hypoglycaemic babies in the first 48 hours after birth”.

She also pointed out dextrose gel can be easily produced in the hospital pharmacy and remains stable at room temperature, making it a useful option in “resource-poor settings” where the condition is common and under-diagnosed.

 

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Readers' comments (2)

  • My baby had hourly glucose feeds which moved his bowels drastically and caused much wind and suffering. He came home from neo-natal ward with a bleedinf bottom! Gel would have been better

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  • using gel still requires monitoring as you may get a fairly quick rise in blood sugar after giving, and just as quick fall if you do not follow by a milk feed to maintain the levels.

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