Insulin Therapy Bad Choice for Preemies
Reported November 01, 2008
(Ivanhoe Newswire) — New research suggests using insulin to control the blood sugar of low-birth-weight infants is not worth the risks.
Infants born with a very low birth weight often suffer from hyperglycemia, or high blood sugar. The problem is associated with illness and death, and recent studies suggest insulin control improves weight gain in newborns with hyperglycemia and a reduced incidence of sepsis. However, a recent study shows early insulin therapy offers little clinical benefit to these patients and may increase hypoglycemia, or low blood sugar — a condition equally as dangerous as its counterpart.
Positive results show infants who received insulin had a lower incidence of hyperglycemia for more than 10 percent in the first week of life than infants who didnt. Infants in the early-insulin group also lost less weight in the first week of life and absorbed more energy than infants in the control group. Negative results show more infants in the early-insulin group suffered from episodes of hypoglycemia, especially in those who weighed more than 1 kg, or 2.2 lbs, at birth. In addition, more infants in the early-insulin group died within 28 days of the beginning of the study.
Study authors wrote, Although intervention improved glucose control, increased energy intake, and reduced weight loss in the first week of life, the failure to show differences in the pre-specified secondary morbidity outcomes, including growth at 28 days, is disappointing.
SOURCE: New England Journal of Medicine, 2008:359:1873-1884