A controlled trial of insulin infusion and parenteral nutrition in extremely low birth weight infants with glucose intolerance

James W. Collins*, Mark Hoppe, Karen Brown, Deborah V. Edidin, James Padbury, Edward S. Ogata

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

103 Scopus citations

Abstract

To determine whether a continuous insulin infusion improves glucose tolerance in extremely low birth weight infants, we conducted a prospective, randomized trial in 24 neonates 4 to 14 days old (mean birth weight 772.9±128 gm; mean gestational age 26.3±1.6 weeks). Infants who had glucose intolerance were randomly assigned to receive either intravenous glucose and total parenteral nutrition with insulin through a microliter-sensitive pump or standard intravenous therapy alone. One infant assigned to recelve insulin never required it. The groups were similar in birth weight, gestational age, race, gender, medical condition, and energy intake before the study. The mean duratio of therapy was 14.6 days (range 7 to 21 days). During the study, the 11 insulin-treated infants tolerated higher glucose infusion rates (20.1±2.5 vs 13.2±3.2 mg/kg/min (1.1±0.1 vs 0.7±0.2 mmol/L); p<0.01), had greater nonprotein energy intake (124.7±18 vs 86.0±6 kcal/kg/day; p<0.01), and had better weight gain (20.1±12.1 vs 7.8±5.1 gm/kg/day; p<0.01) than the 12 control infants. The incidence of hypoglycemia, electrolyte imbalance, chronic lung disease, and death did not differ between groups. We conclude that a controlled insulin infusion improves and sustains glucose tolerance, facilitates provision of calories, and enhances weight gain in glucose-intolerant premature infants.

Original languageEnglish (US)
Pages (from-to)921-927
Number of pages7
JournalThe Journal of pediatrics
Volume118
Issue number6
DOIs
StatePublished - Jun 1991

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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