Is glycosuria a reliable indicator of adequacy of glucose infusion rate in preterm infants?
BACKGROUND
Adequacy of glucose infusion may be monitored via the glycosuria levels, as there is a relationship between glycemia and glycosuria regulated by the renal glucose threshold. In the neonatal period, however, this relationship is not so clear.


OBJECTIVE
To evaluate the occurrence of glycosuria in preferm infants submitted to glucose infusion and to verify the relationship between glycosuria and blood glucose level.


METHODS
Accuracy study.


METHODS
Neonatal intensive care unit of General Maternity Hospital.


METHODS
40 Preterm newborns receiving glucose infusion.


METHODS
511 concomitant determinations of glycemia and glycosuria were performed. These 511 pairs were divided into stable and unstable, according to the clinical status of the newborn at the time of data collection, and they were studied in relation to the gestational age, birth weight and glucose infusion rate.


RESULTS
The results revealed a greater frequency of glycosuria in gestational age < or = 30 weeks, birth weight < 1500 g and glucose infusion rate > 6 mg/kg/min. Eight (25.8%) episodes of positive glycosuria occurred in the absence of hyperglycemia, indicating only a moderate concordance between them.


CONCLUSIONS
Glycosuria alone is an unreliable marker of blood glucose concentration and adequacy of glucose infusion rate. It is therefore necessary to monitor blood glucose levels in infants submitted to continuous glucose infusion.
Department of Paediatrics, Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, Brazil.
M C
MC
Falcão
C R
CR
Leone
J L
JL
Ramos
D015415:Biomarkers; D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D005947:Glucose / Q000008:administration & dosage* / Q000378:metabolism; D006029:Glycosuria / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D007263:Infusions, Parenteral; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies
D015415:Biomarkers; D001786:Blood Glucose; D005947:Glucose