Background Neonatal hypoglycaemia is linked to poor developmental outcome. Dextrose gel reverses hypoglycaemia, but its long term effects are unknown.
Aim To determine two year outcomes of children randomised to dextrose or placebo gel for treatment of neonatal hypoglycaemia1.
Methods At risk babies who became hypoglycaemic (<2.6 mM) were randomised to 40% dextrose or placebo gel. Children were assessed at two years’ corrected age for neurological function and general health (paediatrician assessed); cognitive, language, behaviour and motor skills (Bayley III); executive function; and vision (clinical examination and global motion perception). Primary outcomes were neurosensory disability (cognitive, language or motor score below -1 SD or cerebral palsy or blind or deaf) and processing problem (executive function or global motion perception worse than 1.5 SD). Data are mean (SD), n (%), or relative risk (RR), 95% confidence interval.
Results 184 children were assessed; 90/118 (76%) randomised to dextrose and 94/119 (79%) to placebo gel. Mean birth weight was 3093 (803) g and gestation 37.7 (1.6) wk. 67 children (36%) had neurosensory disability (1 severe, 9 moderate, 57 mild) with similar rates in both groups (dextrose 35 (39%) vs placebo 32 (34%), RR 1.14, 0.78–1.67). Processing difficulty was also similar in both groups (dextrose 8 (10%) vs placebo 16 (18%), RR 0.52, 0.23–1.15).
Discussion Neurosensory disability is common amongst children treated for neonatal hypoglycaemia. Treatment with dextrose gel does not change the incidence of disability or processing problems.
Harris DL, et al. Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study). Lancet 2013;382:2077–83