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Oral Dextrose supplementation


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Dear all,

 

I would like to know the effect of Oral Dextrose supplementation in the management of initial Asymptomatic Hypoglycemia in term babies. How much it is right to give orally? I feel that it can cause rebound Hypoglycemia...So, is that right to give oral dextrose? NB: Neonatal manual by Cloherty and some of the other articles I read, mentions oral dextrose.

 

Thanks,

Mallikarjuna

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Lactose from milk is cleared first pass by the liver after absorption from the intestines and converted to fats. Therefore it does not stimulate insulin secretion  hence it does not cause rebound hypoglycaemia unlike sugar or dextrose solutions. Therefore milk should be the preferred enteral feed esp in IDMs

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Glucose gel appears to be interesting option Dr Stephen, but it is more of preventive rather a treatment strategy. Are we going to use this in all at risk late preterm and term babies?

 

Good point!

But I learnt about one interesting option recently from a French unit where they set a nasogastric tube and use a contineous "feed infusion" to treat hypoglycemia!

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  • 2 years later...

@Urban Rosenqvist sounds great! We still have project plans... :) 

Did you find a protocol somewhere that you translated or did you make your own protocol? Would be great to see the protocol if you want to share it.

We also use fortified milk/formula with Duocal - and sometimes have success with that. But I think your strategy is probably the best.

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@Stefan Johansson Not yet a protocol on it...

Did I understand you correctly - you mean milk/formula given by nasogastric tube driven by a "food pump" 24h a day? Because that´s what we are doing :-)

Usually when the baby is admitted we try starting with normal bolus feeding but if the baby´s having difficulties in tolerating the given amount we switch to food infusion

Sometimes they don´t tolerate 150ml/kg, sometimes they tolerate 220ml/kg or more. We set it to continous infusion (over 24h) and increase it until glucose levels are under control.   

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