Continuous Infusion of Insulin in Hyperglycemic Low-Birth Weight Infants Receiving Parenteral Nutrition with and without Lipid Emulsion

Abstract

The efficiency of a continuous infusion of insulin in improving glucose tolerance was compared in two groups of very low-birth weight infants (mean ± SEM birth weights 757 ± 40 vs 828 ± 80 g and gestational ages 27.6 ± 0.7 vs. 27.2 ± 0.5 weeks) receiving total parenteral nutrition with and without the addition of lipid emulsion to the nutrition regimen. The mean ± SEM cumulative doses of insulin (0.87 ± 0.1 vs 1.15 ± 0.3 U/kg) and hours required to decrease the blood glucose level to 120 mg/dL (9.1 ± 0.8 vs 9.5 ± 1.0 hours) were similar. Insulin was delivered with a syringe pump used for other routine purposes in the neonatal intensive care unit. Continuous intravenous insulin infusion is an effective, inexpensive, safe method for maintaining glucose homeostasis in low-birth weight infants who develop hyperglycemia as a consequence of total parenteral nutrition. (Journal of Parenteral and Enteral Nutrition 15:417-420, 1991)