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Running Head: Continuous Insulin Infusion in Hyperglycemic Extremely-Low-Birth-Weight Neonates
Running Head: Continuous Insulin Infusion in Hyperglycemic Extremely-Low-Birth-Weight Neonates
Hyperglycemia is a significant risk factor for mortality and morbidity in premature newborns
1033 ] .
Hyperglycemia has been reported to occur more frequently in infants weighing! 1,000 g
[ CITATION Dit99 \l 1033 ]. The inability of the newborn to inhibit gluconeogenesis in response to a
glucose infusion leading to insulin resistance has been postulated as an important cause of
Treatment of Hyperglycemia
Studies have shown that insulin infusion is more important than plasma glucose reduction in the
regulation of glucose homeostasis in these infants [ CITATION Sun94 \l 1033 ]. The American
Academy of Pediatric Nutrition has recommended maintaining adequate calorie intake during
[ CITATION Gol80 \l 1033 ]. Insulin infusion improves glucose tolerance in low-birth-weight infants
and allows hyperglycemic infants to achieve adequate energy intake similar to that of infants
who do not become hyperglycemic [ CITATION Mee98 \l 1033 ]. This facilitates neonatal growth
and enhances developmental outcome [ CITATION Zyl01 \l 1033 ]. Conditions that cause stress to
infants such as respiratory distress, sepsis, surgery and administration of corticosteroids may
Reference
Cowett RM, Andersen GE, & Maguire CA, Oh. (1988). Ontogeny of glucose homeostasis in low
Ditzenberger GR, Collins SD, & Binder N. (1999). Continuous insulin intravenous infusion
Goldman SL, & Hirata T. (1980). Attenuated response to insulin in very low birth weight infants.
Sunehag A, Gustaffson J, & Ewald U. (1994). Very immature infants ( ! or = 30 weeks) respond
toglucose infusion with incomplete suppressionof glucose production. Pediatr Res, 36,
550-555.
214-221.
YE, V., Walson PD, & Morrow III G. (1982). Continuous insulin infusion in hyperglycemic very
Zylberberg R, & Pepper M. (2001). Continuous insulin infusion: Promoting growth in low birth