December 1, 20168 yr comment_8867 There seems to be a little confusion around the use of Dextrose gel - it is used as a treatment for hypoglycemia.I believe there are other studies underway looking at other ways to use it, but this is how our unit has used it for many years now. We give 0.5ml (cc) per kg of bodyweight applied directly to the buccal membranes with a gloved finger. The baby will then be fed and the BGL checked in 30 minutes. We have not noticed any rebound hypoglycemia. I am not sure what is meant by Asymptomatic hypoglycemia - in our experience checking the blood glucose is the only way to ascertain whether a baby is hypoglycemic or not.
December 1, 20168 yr @JoannieO i think this thread has become a bit confusing, sorry for that. So you use sugar gel as treatment of diagnosed hypoglycemia? I thought the sugarbaby-trial was a prevention trial incl risk groups at the maternity ward (i.e. Risk groups for hypoglycemia), but I may be wrong by memory. For infants sdmitted to the nicu, Will gel also be usually succesful so you can spare a baby an iv infusion of glucose? The feeding pump discussion is a separete topic from gel admin, but I think an attractive mode of admin compared to iv infusion of glucose (and very much OT - our main concern is our glucose measurement apparatus...)
December 6, 20168 yr On the OT: The same here... To reduce pain we changed several years ago from heel lancing using a stationary meter to the mobile Freestyle Lite blood glucose meter. After that we had to deal with, and treat a lot more "hypoglycemias". After changing to another model of Freestyle we now see less hypoglycemias.
December 6, 20168 yr comment_8876 The Sugar babies trial did indeed look at babies at risk of hypoglycemia, however, in our unit we have used dextrose gel as a first line treatment for hypoglycemia for many years. The Sugar babies trial and associated research provided us with the evidence that we needed to underpin this practice. We use the BD lancet for heelsticks and process the sample immediately - we are lucky enough to have a blood gas analyzer on our unit. Using dextrose gel as a first treatment, along with feeding, has meant that most babies can be managed without IV fluids. We prefer to feed breast milk whenever possible, and don't use formula without parental consent. Sometimes there will be a baby who is on IV fluids until there is enough breast milk if the parents don't want the baby to have formula, but we don't often have babies on IV fluids because of hypoglycemia.
December 14, 20168 yr Can I ask how you all measure blood sugars and whether there is any evidence of blood gas machines versus BM sticks
December 15, 20168 yr @spartacus007 we currently use "Freestyle light" (https://freestylediabetes.co.uk/our-products/other-meters/freestyle-lite) and it performs poorly... as it often under-estimates the true value (shows a hypoglycemic value when there is normoglycemia. We are currently validating Accucheck and Freestyle Pro against our blood gas machine (ABL90) that has accreditation as reference for glucose measurement. We plan to publish of course, but my impression (without statistical testing) is that both seem to perform reasonably well.
December 16, 20168 yr We are moving to use of I stat machine based testing. Is any one else using them Alok
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