Background We have shown that hyperalimentation using a Standardised, Concentrated, Added Macronutrients Parenteral (SCAMP) nutrition regimen improves early head growth. Hyperglycaemia hinders hyperalimentation strategies in very preterm infants (VPI) in the first 14 days of life. Insulin-treated hyperglycaemia (ITH) avoids the need to reduce glucose intake, although the evidence for benefit is limited. We hypothesised that VPI with ITH would achieve optimal growth with hyperalimentation.

Methods SCAMP and control groups were identified from the previously published RCT (ISRCTN 76597892). Infants were substratified into ITH and non-ITH within their original group randomisation. Hyperglycaemia necessitating insulin treatment required 2 consecutive blood glucose measurements >12mmol/l. Actual mean daily protein/energy intake data and weekly measurements of head circumference (HC) and weight were collected d1–28.

Results Mean (sd) daily protein/energy intake and change in HC (ΔHC) and weight (ΔWt) between birth and d14 are summarised in Table 1.

Conclusions ITH is associated with optimal early growth when combined with hyperalimentation.