Insulin infusion for hyperglycaemia in very preterm infants appears safe with no effect on morbidity, mortality and long-term neurodevelopmental outcome.
OBJECTIVE
Hyperglycaemia is common in very premature neonates and is associated with increased risk of intraventricular haemorrhage, necrotising enterocolitis, sepsis and death. Administration of insulin may risk hypoglycaemia and associated complications. To determine effects of insulin infusions in very premature infants on morbidity, mortality and long-term neurodevelopmental outcome.


METHODS
Retrospective audit of 97 infants delivered at <29 weeks gestation and admitted to The Canberra Hospital NICU. Data on insulin treatment, Blood Glucose Levels (BGL's) prior and during insulin therapy, episodes of significant hypoglycaemia and neurodevelopmental outcome at 12 months corrected age was collected.


RESULTS
17 (17.5%) neonates received insulin. Episodes of hypoglycaemia were infrequent (1.3%, 95% CI 0.5-2.9). Multiple regression analysis showed that insulin treatment was not associated with an increased risk of retinopathy of prematurity (OR 3.6, 95% CI 0.4-32.3) or mortality (OR 1.2, 95% CI 0.29-5.0). No significant difference in 12 month neurodevelopmental or anthropometric outcomes was detected in infants who received insulin.


CONCLUSIONS
Insulin infusions for hyperglycaemia appear to be safe with infrequent episodes of hypoglycaemia, no increased risk of morbidity or mortality and no adverse effect on long-term neurodevelopmental outcome.
Australian National University Medical School, Canberra, 2601, ACT, Australia.
Alicia
A
Heald
Mohamed E
ME
Abdel-Latif
Alison L
AL
Kent
D001921:Brain / Q000187:drug effects / Q000254:growth & development*; D002657:Child Development / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000151:congenital / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D062071:Infant, Extremely Premature / Q000254:growth & development / Q000378:metabolism / Q000502:physiology; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D007332:Insulin Infusion Systems; D008297:Male; D009017:Morbidity; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
D007328:Insulin