mallikarjuna78 Posted January 2, 2014 Share Posted January 2, 2014 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 1 Link to comment Share on other sites More sharing options...
Stefan Johansson Posted January 8, 2014 Share Posted January 8, 2014 Take a look at the topic about sugar gel give orally, a research article published in the Lancet: I think you can find some in the Methods section about how they actually did the study. Link to comment Share on other sites More sharing options...
kpsanghvi Posted January 10, 2014 Share Posted January 10, 2014 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 Link to comment Share on other sites More sharing options...
vijayashankara Posted January 12, 2014 Share Posted January 12, 2014 I agree with dr Sangvi, oral dextrose 5% or more can also cause osmotic diarrhea, if one wants Extra calories one can use HMF with EBM or polycose in proper dilution. Link to comment Share on other sites More sharing options...
vijayashankara Posted January 12, 2014 Share Posted January 12, 2014 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? 1 Link to comment Share on other sites More sharing options...
Stefan Johansson Posted January 12, 2014 Share Posted January 12, 2014 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! Link to comment Share on other sites More sharing options...
Urban Rosenqvist Posted November 21, 2016 Share Posted November 21, 2016 Stefan: We do that as well. We have no study on it but since roughly 2 years ago our need for intravenous infusion has dropped. After discussion with ALB hospital we learned that they are successful in preventing i.v. treatment when giving a supplement of oral Duocal (brand name - carbohydrates/fat) to breast milk. 1 Link to comment Share on other sites More sharing options...
Stefan Johansson Posted November 21, 2016 Share Posted November 21, 2016 @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. Link to comment Share on other sites More sharing options...
Urban Rosenqvist Posted November 24, 2016 Share Posted November 24, 2016 @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. 1 Link to comment Share on other sites More sharing options...
Stefan Johansson Posted November 25, 2016 Share Posted November 25, 2016 @Urban Rosenqvist yes, a feeding pump is exactly what I was referring to. Sounds great to hear you have experience with this - maybe we should consider to make a trial (that something we would like to do, randomize to feeding pump vs iv glucose) Link to comment Share on other sites More sharing options...
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