A Sweet Addition for the Treatment of Neonatal Hypoglycemia.

In this issue of The Journal, Harris et al1 report the neurodevelopmental outcomes at 2 years corrected age in children randomized to treatment with dextrose gel or placebo for asymptomatic neonatal hypoglycemia (the Sugar Babies Study). All infants enrolled in this single-center trial were between 35 and 42 weeks gestational age and at risk for neonatal hypoglycemia due to late prematurity, maternal diabetes, or small or large birthweight for gestational age. Some were also included for poor feeding, which could be considered a symptom of hypoglycemia.2 Screening for hypoglycemia (blood glucose concentration <2.6 mM or 47 mg/dL) was rigorous with glucose concentrations measured 1 hour after birth, every 3-4 hours before feeds for the first 24 hours, and every 6-8 hours for the next 24 hours. Using this protocol, 46% of the enrolled patients were identified as hypoglycemic and randomized to receive dextrose gel or placebo in conjunction with encouragement to breast feed. If feeding was poor, the infant was given expressed breast milk or formula by syringe. Neurodevelopmental outcomes at 2 years of age are available for 78% of the original hypoglycemic cohort. Rates of neurosensory impairment, processing difficulties, and multiple secondary growth and developmental outcomes were equivalent between the dextrose gel and placebo groups.