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Dilemmas in parenteral glucose delivery and approach to glucose monitoring and interpretation in the neonate

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Abstract

Glucose control continues to be challenging for intensivists, in particular in high-risk neonates. Many factors play a role in glucose regulation including intrinsic and extrinsic factors. Optimal targets for euglycemia are debatable with uncertain short and long-term effects. Glucose measurement technology has continued to advance over the past decade; unfortunately, the availability of these advanced devices outside of research continues to be problematic. Treatment approaches should be individualized depending on etiology, symptoms, and neonatal conditions. Glucose infusions should be titrated based upon variations in organ glucose uptake, co-morbidities and postnatal development. In this article we summarize the most common dilemmas encountered in the NICU: ranges for euglycemia, physiological differences, approach for glucose measurements, monitoring and best strategies to control parenteral glucose delivery.

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Funding

Funding

All data utilized in this review has been published and funding sources are detailed in each manuscript referenced.

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Authors and Affiliations

  1. Department of Pediatrics, University of Texas Health Science Center San Antonio, San Antonio, TX, USA

    Cynthia L. Blanco & Victor Smith

  2. Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA

    Sara E. Ramel

  3. Department of Pediatrics, Weill Cornell Medicine, New York, NY, USA

    Camilia R. Martin

Authors
  1. Cynthia L. Blanco
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  2. Victor Smith
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  4. Camilia R. Martin
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Contributions

CB, VS, SR and CM conceptualized and designed the study. Drafting of the manuscript was done by CB, VS. Critical revision of the manuscript for important intellectual content was done by all authors.

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Correspondence to Cynthia L. Blanco.

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Blanco, C.L., Smith, V., Ramel, S.E. et al. Dilemmas in parenteral glucose delivery and approach to glucose monitoring and interpretation in the neonate. J Perinatol 43, 1200–1205 (2023). https://doi.org/10.1038/s41372-023-01640-5

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