Running head: CONTINUOUS INSULIN INFUSION IN HYPERGLYCEMIC

EXTREMELY-LOW- BIRTH-WEIGHT NEONATES

Continuous Insulin Infusion in Hyperglycemic Extremely-Low- Birth-Weight Neonates

Student name: Ajman S. Kadham

University of Baghdad College of nurse

CONTINUOUS INSULIN INFUSION IN HYPERGLYCEMIC EXTREMELY-LOW-
BIRTH-WEIGHT NEONATES
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Continuous Insulin Infusion in Hyperglycemic Extremely-Low- Birth-Weight Neonates

Hyperglycemia is a significant risk factor for mortality and morbidity in premature newborns

and it occurs in 40–80% of extremely-low-birth-weight (ELBW)1 infants[CITATION Mee98 \l

1033 ] .

Factor That Effect on Hyperglycemia

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

hyperglycemia observed in premature infants [ CITATION Cow88 \l 1033 ].

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

parenteral nutrition of hyperglycemic extremely premature infants by using insulin infusion

[ 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

induce Hyperglycemia in premature neonates [ CITATION YEV82 \l 1033 ].

1 Extremely-Low- Birth-Weight Neonates

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BIRTH-WEIGHT NEONATES
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Reference

Cowett RM, Andersen GE, & Maguire CA, Oh. (1988). Ontogeny of glucose homeostasis in low

birth weight infants. J Pediatr, 112, 462-465.

Ditzenberger GR, Collins SD, & Binder N. (1999). Continuous insulin intravenous infusion

therapy for VLBW infants. J Perinat Neonat Nurs, 70-82.

Goldman SL, & Hirata T. (1980). Attenuated response to insulin in very low birth weight infants.

Pediatr Res, 14, 50-53.

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.

W, M., Bowsher R, & Compton J. (1998). Hyperglycemia in extremely-low-birth. Biol Neonate,

214-221.

YE, V., Walson PD, & Morrow III G. (1982). Continuous insulin infusion in hyperglycemic very

low birth weight infants. J Pediatr Gastroenterol Nutr , 1, 211-217.

Zylberberg R, & Pepper M. (2001). Continuous insulin infusion: Promoting growth in low birth

weight infants. Neonatal Network, 20, 17-20.

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BIRTH-WEIGHT NEONATES
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