I guess many of you read about the Sugar Babies Study, about giving dextrose gel to (well) infants at risk of developing hypoglycemia.

 

Link to the paper in Lancet: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2961645-1/abstract

 

I would be glad to hear more from people with experience from this treatment, involved in the trial or having experience outside the trial.

- is the gel produced by pharmacies "in-house" or bought from a manufacturer?

- who is administrating the gel (midwife, nurse, doctor?)

- dose weight-dependent (SGA vs LGA babies)?

- experience regarding b-glucose and admissions to the NICU?

 

etc...

Dear Dr Stefan Greetings

Ever heard about this

Could you please tell us something more about this innovative therapy!

Reading the Methods in the manuscript tells:

- the gel was 40% glucose and prepared by the hospital pharmacy

- dose was 0.5 ml/kg, "massaged" into the buccal surface and before a feed

- administration was done by midwifes (or researcher involved in the study).

 

I feel keen to test this in our hospital!

The study was carried out in the hospital where I work.  In the special care nurseries (Level 2) we have used it for many years with very good results. We are all very proud of Deborah Harris, who was the lead researcher. During the study the gel was administered by both midwives and nurses, depending on whether the baby was in the post-natal wards or the NICU.  We dry the buccal mucosa with a gauze swab and "massage" the gel into the mucosa with a gloved finger.  The babies did not seem disturbed by this, and as the study results show, it works very well.

@JoanneO - very interesting that you use it for years. I will make a serious attempt to introduce this method at the hospital I will be moving in Febr. Send my best regards to Deborah Harris!

Hi.

Here in Spain we have DiaBalance expert, for diabetes hypoglicemia, but has flavour and conservant.

I wite to the autors about what kind of dextrosa tey use.

The problem for us is contamination of the dextrosa prepared in pharmacy.

Any way, the autor send me all information.

As soon as possible I will send you all this information.

Is a very interest way to treat, and in my hospital we are very interested.

Email from Jane Harding .
Very polite in her e-mail. Here you have.

Dear Dr Roca,



Thank you for your interest in our study. Unfortunately I don't know if I can be very much help to you. The preparation we have used clinically is made up by the hospital pharmacist in bulk as a simple 40% dextrose solution (ie from bulk purchased dextrose powder), and dispensed in 100ml pots. The required dose is drawn up in a syringe from the pot. For the studies we have ongoing at present the gel is prepared in 5 ml syringes, which is essentially a unit dose, but we did not do that with for the Sugar Babies study, and the pots, which sit in each ward and room in NICU, have been used for some years without problems. I believe the pots are given a 1 month expiry date when used in this fashion, although our formal testing indicates that there can be at least a 6 month shelf life, and probably more (we are just testing this at the moment for the syringes). There are also a number of commercial gel preparations available, marketed for diabetics, although some of them are flavoured and not suitable for babies. The one most commonly available here is called Hypo-Stop, but again, we did not use a commercial preparation because our pharmacy found it easy and cheap to formulate.

I don't know if this helps you. Unfortunately the key pharmacist for our trial has left, but the team at Biomed (http://2cu.co.nz/auckland/listings/74185-biomed-limited) are the people who are currently making our gel, and supply it to many hospitals in NZ. I am sure they would be happy to try to assist if you had additional questions that I can't answer.

I hope you are able to access some gel and find that it helps keep babies out of NICU.

Best wishes

Jane

We are also considering using dextrose gel for asymptomatic neonatal hypoglycemia in our unit. I would be very interested to know if anyone has experience in their hospital pharmacy compounding the 40% dextrose gel so it could be administered preservative free. It appears that the only commercially available dextrose gels here in the U.S. contain methyl and propyl parabens as preservatives. I am curious how the New Zealand group maintains sterility of their dextrose gel over long periods of time. Do they keep it refrigerated? Anyway, the commercially available dextrose gel here in the U.S. is called glutose 15 (Paddock Laboratories, Inc.). Here is a link that outlines all of the ingredients: http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ba2522af-e664-47ef-b93b-63f12fcfb1ea#nlm34071-1

The kid of the question: how to prepared it¡¡¡

We do not refrigerated dextrose gel as the manufacturer tells us it is not necessary.  We draw it up in a new syringe as needed.  The bottle is discarded one month after opening. We have never had a problem with contamination, and as far as I know there are no preservatives in it.  The manufacturer would be able to give you this information.