Dextrose Gel Could Protect Newborns from Brain Damage

A new study suggests that common dextrose gel could be used to cure neonatal hypoglycemia, a common problem that can lead to brain damage in up to 15% of otherwise healthy babies.

Researchers at the University of Auckland (New Zealand) conducted a randomized, double-blind, placebo-controlled study (The Sugar Babies Study) between 2008 and 2010, involving 514 at-risk babies from Waikato Women's Hospital (Hamilton, New Zealand), who were enrolled in the scheme within 48 hours after birth; 242 babies (47%) became hypoglycemic, and were randomized to 40% dextrose gel 200 mg/kg or placebo gel. Allocation was concealed from clinicians, families, and all study investigators. The primary outcome was treatment failure, defined as a blood glucose concentration lower than 2.6 mmol/L after two treatment attempts.

The results showed that dextrose gel reduced the frequency of treatment failure (16%) compared with placebo (24%), for a relative risk (RR) of 0.57. The researchers noted no serious adverse events, with 3% of the babies in the placebo group with one blood glucose concentration of 0.9 mmol/L; no other adverse events took place. The babies given dextrose gel were also less likely to be admitted to the neonatal intensive care unit (nICU) for hypoglycemia, to receive additional formula feeds, and were more likely to breast feed successfully. The study was published early online on September 25, 2013, in the Lancet.

“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 hypoglycemia, and is safe and simple to use,” said lead author leader Prof. Jane Harding, MD. “Dextrose gel treatment costs roughly NZD 2 per baby and could help reduce admissions to neonatal intensive care for treatment with intravenous glucose, not only reducing costs but importantly, keeping mothers and babies together to encourage breastfeeding.”

Neonatal hypoglycemia, also known as low blood sugar, is preventable, but current treatments are laborious, invasive, and uncomfortable for babies, involving extra feeding and repeated blood tests to measure blood sugar levels. However, this is often unsuccessful, and many babies are admitted to nICUs and given intravenous glucose because their blood sugar remains low.

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