Dextrose gel reduces need for intravenous fluids in babies with asymptomatic hypoglycaemia

In neonates who have asymptomatic hypoglycaemia in the first 48 hours of life, administering dextrose gel is useful and minimizes requirement for intravenous fluids, as shown in a study.

The study included 629 at-risk infants with asymptomatic hypoglycaemia. They were randomly assigned to the intervention group, which received dextrose gel followed by breastfeeding, or the control group, which received only breast feeding.

Researchers grouped the neonates into the following: small for gestational age (SGA) and intrauterine growth-restriction (IUGR), infants of diabetic mothers (IDM) and large for gestational age (LGA), and late preterm (LPT) neonates.

A total of 291 (46 percent) neonates developed asymptomatic hypoglycaemia, including 147 (50.4 percent) in the intervention group and 144 (49.6 percent) in the control group. The corresponding subgroup distribution was 97 infants in SGA/IUGR, 98 in IDM/LGA, and 96 in LPT.

Compared with control, the intervention resulted in a lower incidence of treatment failure or intravenous fluids requirement (11.5 percent vs 40.2 percent; risk ratio, 0.28, 95 percent confidence interval [CI], 0.17–0.46; p<0.001).

Likewise, treatment failure occurred at significantly lower frequency among infants who received additional dextrose gel than among those who were breastfed alone across the SGA/IUGR (risk ratio, 0.29, 95 percent CI, 0.13–0.67), IDM/LGA (risk ratio, 0.31, 95 percent CI, 0.14–0.66), and LPT (risk ratio, 0.24, 95 percent CI, 0.09–0.66) subgroups.