Glucose Tolerance in Very Low Birthweight Infants

Abstract

Yu, V. Y. H., James, B. E., Hendry, P. G. and MacMahon, R. A. (1979). Aust. Paediatr. J., 15, 147–151 Glucose tolerance in very low birthweight infants. The carbohydrate intake and incidence of hyperglycaemia were reviewed in 40 very low birthweight infants with a birthweight of less than 1200g who were randomly assigned to total parenteral nutrition (TPN) or oral (MILK) feeding regimens during the first two weeks after birth. With increasing glucose tolerance after birth, the carbohydrate intake was increased from a mean intake of 8g/kg.d on Day 1 to 17g/kg.d in the TPN group and 12g/kg.d in the MILK group by the second week; the lower intake in the latter group was due to a restricted intake rather than decreased glucose tolerance. Twenty‐seven per cent of the infants had moderate or severe hyperglycaemia in the first week compared with 13% in the second week, in spite of the higher carbohydrate intake in the latter period. All hyperglycaemic episodes were corrected promptly without obvious serious sequelae by decreasing the rate of carbohydrate intake. The rational approach to carbohydrate administration in the very low birthweight infant includes the calculation of carbohydrate intake in terms of g/kg.d (rather than arbitrary concentrations given at variable rates based on fluid requirement), a constant infusion at a steady rate, and the close monitoring of blood glucose to establish glucose tolerance limits which increase with postnatal age.