'Sugar gel' protects newborns with low blood sugar

A cheap and easy-to-administer 'sugar gel' can help prevent brain damage in newborns with low blood sugar levels, scientists have found.
Low blood sugar or neonatal hypoglycaemia is a common problem that affects up to 15 per cent of otherwise healthy babies and is a preventable cause of brain damage, said Professor Jane Harding from the University of Auckland.
In a study, researchers at the University's Liggins Institute and at Waikato Women's Hospital in Hamilton, New Zealand, assessed whether treatment with dextrose gel, an oral glucose gel, is more effective than feeding alone at reversing neonatal hypoglycaemia in at-risk babies (eg, from pregnancies complicated by maternal diabetes, preterm birth, and low birthweight).

"Our study is the first report in babies showing that dextrose gel massaged into the inside of the cheek is more effective than feeding alone for treating hypoglycaemia, and is safe and simple to use," said Harding.
Dextrose gel is already used to reverse hypoglycaemia in people with diabetes, but little evidence exists for its use in babies.
Currently, treatment for late preterm and term babies involves extra feeding and repeated blood tests to measure blood sugar levels. But many babies are admitted to intensive care and given intravenous glucose because their blood sugar remains low.

In the study, between 2008 and 2010, 514 at-risk babies aged 35 weeks gestation or older from Waikato Women's Hospital in Hamilton were enrolled in the first 48 hours after birth.

Around 242 (47 per cent) became hypoglycaemic and were randomly assigned to 40 per cent dextrose gel or placebo gel for up to six doses over 48 hours.
Treatment with dextrose almost halved the likelihood of treatment failure compared with placebo, with no adverse effects.
Babies given dextrose gel were also less likely to be admitted to intensive care for hypoglycaemia, to receive additional formula feeds, and to be formula fed at two weeks.
"Because this treatment is inexpensive and simple to administer, it should be considered for first-line management of late preterm and term hypoglycaemic babies in the first 48 hours after birth," Harding said.

"Dextrose gel can easily be made in the hospital pharmacy, and is stable at room temperature. Therefore, the gel could also be useful in resource-poor settings where hypoglycaemia is common and underdiagnosed," she said.
The study was published in the The Lancet journal.