Neonatal blood glucose concentrations: metabolic effects of intravenous glucagon and intragastric medium chain triglyceride.
Neonatal hypoglycaemia is a common clinical problem and the traditional treatment for the condition is intravenous glucose administration. The glycaemic effects of two additional treatments were investigated, in a randomised trial, in 23 neonates who were receiving intravenous glucose as treatment for hypoglycaemia. Eleven infants received an intravenous bolus dose of glucagon (200 micrograms/kg) and 12 infants received intragastric medium chain triglyceride (MCT) (5 ml/kg). Blood concentrations of glucose and intermediary metabolites were measured before and one hour after treatment, and, using stable isotope infusion, glucose production rates were calculated. After glucagon, there was a mean rise in blood glucose concentration of 1.6 mmol/l and in the glucose production rate of 2.6 mg/kg/min. After MCT, there was a small mean rise in blood glucose concentration of 0.4 mmol/l, but the effect of MCT on glucose production rate was variable. Intravenous bolus glucagon administration exerted a glycaemic effect which was associated with an increase in glucose production rate. The use of glucagon, as an alternative treatment to intravenous glucose, should be investigated further.
Hawdon
J M
JM
Department of Child Health, University of Newcastle upon Tyne.
Aynsley-Green
A
A
Ward Platt
M P
MP
D001786:Blood Glucose / Q000378:metabolism*; D004334:Drug Administration Schedule; D005934:Glucagon / Q000008:administration & dosage*; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000628:therapy; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007322:Instillation, Drug; D007328:Insulin / Q000097:blood; D014280:Triglycerides / Q000008:administration & dosage*
D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D005934:Glucagon; D005947:Glucose