A cheap and easy-to-administer dextrose gel should be used to treat low blood sugars in newborns, according to New Zealand research just published in the international medical journal, The Lancet.
Low blood sugar or neonatal hypoglycaemia is a common problem that affects up to 15 per cent of otherwise healthy babies and is a preventable cause of brain damage, says study leader Professor Jane Harding from The University of Auckland.
The research was carried out at the university’s Liggins Institute and at Waikato Women’s Hospital in Hamilton where PhD student and Neonatal Nurse Practitioner Deborah Harris recruited the families involved.
The Health Research Council of New Zealand (HRC) provided financial support for the project, along with other funders including the Waikato Medical Research Foundation and the Auckland Medical Research Foundation.
“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 hypoglycaemia, and is safe and simple to use,” says Professor Harding.
“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 Sugar Babies Study was designed to assess whether treatment with dextrose gel is more effective than feeding alone at reversing neonatal hypoglycaemia in at-risk babies (eg, from pregnancies complicated by maternal diabetes, preterm birth and low birthweight).
Between 2008 and 2010, 514 at-risk babies aged 35 weeks gestation or older from Waikato Women’s Hospital were enrolled in the first 48 hours after birth. 242 (47 per cent) became hypoglycaemic and were randomly assigned to 40 per cent dextrose gel or placebo gel for up to six doses over 48 hours.
Treatment with dextrose almost halved the likelihood of treatment failure (a blood glucose concentration of less than 2.6 mmol/L 30 min after the second of two doses of gel) compared with placebo, with no adverse effects.
Babies given dextrose gel were also less likely to be admitted to intensive care for hypoglycaemia, to receive additional formula feeds, and to be formula fed at two weeks.
In June this year, Professor Harding was awarded $1,197,339 in the HRC's annual funding round to test the dextrose gel treatment in a randomised trial.
"We have shown that oral dextrose gel is effective in reversing hypoglycaemia, halving NICU (Neonatal Intensive Care Unit) admission rates and improving rates of breast-feeding," says Professor Harding. "This randomised trial will now investigate the effectiveness of dextrose gel for prevention of hypoglycaemia and its consequences."