Effect of enteral administration of insulin on intestinal development and feeding tolerance in preterm infants: a pilot study.
OBJECTIVE
To determine in a pilot study whether enteral administration of insulin to preterm infants (26-29 weeks of gestational age) would enhance gastrointestinal development and reduce feed intolerance without adverse effects.


METHODS
Eight preterm infants were given 4 U/kg/day insulin enterally from 4 to 28 days of age. Lactase activity was measured at 28 days of age, while measures of feed intolerance were made throughout the hospital stay. The results were compared with those of a matched historical cohort of 80 preterm infants.


METHODS
Tertiary care, university affiliated hospital.


METHODS
Lactase activity and feed intolerance.


RESULTS
No adverse effects, such as hypoglycaemia, were observed after administration of insulin. The infants who received insulin had higher lactase activity and less feed intolerance than the controls (30% shorter time to full enteral feeds; fewer gastric residuals per infant).


CONCLUSIONS
These preliminary data suggest that enteral insulin administration may be of benefit in reducing feed intolerance in preterm infants. A randomised, blinded trial is warranted.
Shulman
R J
RJ
USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, and Texas Children's Hospital, Houston, Texas, USA. rshulman@bcm.tmc.edu
D004064:Digestive System / Q000187:drug effects / Q000201:enzymology / Q000254:growth & development*; D004750:Enteral Nutrition; D005746:Gastric Emptying / Q000187:drug effects*; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007328:Insulin / Q000494:pharmacology*; D043322:Lactase; D010865:Pilot Projects; D013997:Time Factors; D001616:beta-Galactosidase / Q000378:metabolism
D007328:Insulin; D043322:Lactase; D001616:beta-Galactosidase