Improving blood glucose in late preterm and small for gestational age infants: the use of dextrose 40% gel

IntroductionLimited evidence exists on whether administering oral dextrose gel immediately after birth reduces the risk of hypoglycemia in the early hours of life. The primary objective of this study was to assess whether early administration of 40% dextrose gel in infants with risk factors could re...

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Main Authors: Paola Polo Perucchin, Elena Aldera, Maria Grazia Calevo, Bianca De Grande, Monica Russo, Elisabetta Godano, Mohamad Maghnie, Cesare Arioni
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1591567/full
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author Paola Polo Perucchin
Elena Aldera
Maria Grazia Calevo
Bianca De Grande
Monica Russo
Elisabetta Godano
Mohamad Maghnie
Mohamad Maghnie
Cesare Arioni
author_facet Paola Polo Perucchin
Elena Aldera
Maria Grazia Calevo
Bianca De Grande
Monica Russo
Elisabetta Godano
Mohamad Maghnie
Mohamad Maghnie
Cesare Arioni
author_sort Paola Polo Perucchin
collection DOAJ
description IntroductionLimited evidence exists on whether administering oral dextrose gel immediately after birth reduces the risk of hypoglycemia in the early hours of life. The primary objective of this study was to assess whether early administration of 40% dextrose gel in infants with risk factors could reduce the incidence of hypoglycemia during the first few hours after birth. A secondary aim was to evaluate the impact of early dextrose gel administration on breastfeeding outcomes.MethodsThis was a double-arm, randomized trial conducted in two phases that included a total of 297 patients. In the first phase, 200 infants at risk for hypoglycemia were recruited including those who were small for gestational age (SGA), late preterm (LP, born between 34 + 0 and 36 + 6 weeks), large for gestational age (LGA), and infants of diabetic mothers: 100 infants were assigned to the “Dextrose group” and received 40% dextrose oral gel 15 minutes after birth, 100 infants in the “Control group” did not receive any dextrose. Capillary blood glucose was measured at 2 and 4 hours of life. Based on the preliminary findings, the second phase of the study randomized an additional 97 LP infants: 50 in the dextrose group and 47 in the control group, following the same intervention protocol.ResultsIn the first phase, no significant differences in blood glucose levels were found at 2 and 4 hours of life in infants of diabetic mothers or those who were LGA. In SGA infants blood glucose levels tended to decrease significantly between 2 and 4 hours in the control group. In the second phase, LP infants who received dextrose had significantly higher blood glucose at 2 hours compared to those in the control group. Additionally, LP infants in the dextrose group who were breastfed within the first two hours showed significantly higher blood glucose at two hours than those in the control group.DiscussionEarly administration of 40% dextrose gel may be beneficial in maintaining higher blood glucose levels during the first hours of life in LP and SGA infants; our findings suggest that only in LP and SGA patients early intervention with dextrose gel could support glucose homeostasis and potentially improve breastfeeding outcomes.
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spelling doaj-art-9d04a3adf99c434fb398912ac2bb43bb2025-08-20T03:16:16ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-06-011310.3389/fped.2025.15915671591567Improving blood glucose in late preterm and small for gestational age infants: the use of dextrose 40% gelPaola Polo Perucchin0Elena Aldera1Maria Grazia Calevo2Bianca De Grande3Monica Russo4Elisabetta Godano5Mohamad Maghnie6Mohamad Maghnie7Cesare Arioni8Neonatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, IT, ItalyPaediatric Unit, Ospedale Cardinal Massaia, Asti, IT, ItalyEpidemiology and Biostatistics Unit, Scientific Directorate, IRCCS Istituto Giannina Gaslini, Genoa, IT, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, IT, ItalyNeonatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, IT, ItalyNeonatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, IT, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, IT, ItalyDepartment of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa, IT, ItalyNeonatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, IT, ItalyIntroductionLimited evidence exists on whether administering oral dextrose gel immediately after birth reduces the risk of hypoglycemia in the early hours of life. The primary objective of this study was to assess whether early administration of 40% dextrose gel in infants with risk factors could reduce the incidence of hypoglycemia during the first few hours after birth. A secondary aim was to evaluate the impact of early dextrose gel administration on breastfeeding outcomes.MethodsThis was a double-arm, randomized trial conducted in two phases that included a total of 297 patients. In the first phase, 200 infants at risk for hypoglycemia were recruited including those who were small for gestational age (SGA), late preterm (LP, born between 34 + 0 and 36 + 6 weeks), large for gestational age (LGA), and infants of diabetic mothers: 100 infants were assigned to the “Dextrose group” and received 40% dextrose oral gel 15 minutes after birth, 100 infants in the “Control group” did not receive any dextrose. Capillary blood glucose was measured at 2 and 4 hours of life. Based on the preliminary findings, the second phase of the study randomized an additional 97 LP infants: 50 in the dextrose group and 47 in the control group, following the same intervention protocol.ResultsIn the first phase, no significant differences in blood glucose levels were found at 2 and 4 hours of life in infants of diabetic mothers or those who were LGA. In SGA infants blood glucose levels tended to decrease significantly between 2 and 4 hours in the control group. In the second phase, LP infants who received dextrose had significantly higher blood glucose at 2 hours compared to those in the control group. Additionally, LP infants in the dextrose group who were breastfed within the first two hours showed significantly higher blood glucose at two hours than those in the control group.DiscussionEarly administration of 40% dextrose gel may be beneficial in maintaining higher blood glucose levels during the first hours of life in LP and SGA infants; our findings suggest that only in LP and SGA patients early intervention with dextrose gel could support glucose homeostasis and potentially improve breastfeeding outcomes.https://www.frontiersin.org/articles/10.3389/fped.2025.1591567/fullhypoglycemiaoral dextrose gellate pretermsmall for gestational agelarge for gestational agechildren of diabetic mothers
spellingShingle Paola Polo Perucchin
Elena Aldera
Maria Grazia Calevo
Bianca De Grande
Monica Russo
Elisabetta Godano
Mohamad Maghnie
Mohamad Maghnie
Cesare Arioni
Improving blood glucose in late preterm and small for gestational age infants: the use of dextrose 40% gel
Frontiers in Pediatrics
hypoglycemia
oral dextrose gel
late preterm
small for gestational age
large for gestational age
children of diabetic mothers
title Improving blood glucose in late preterm and small for gestational age infants: the use of dextrose 40% gel
title_full Improving blood glucose in late preterm and small for gestational age infants: the use of dextrose 40% gel
title_fullStr Improving blood glucose in late preterm and small for gestational age infants: the use of dextrose 40% gel
title_full_unstemmed Improving blood glucose in late preterm and small for gestational age infants: the use of dextrose 40% gel
title_short Improving blood glucose in late preterm and small for gestational age infants: the use of dextrose 40% gel
title_sort improving blood glucose in late preterm and small for gestational age infants the use of dextrose 40 gel
topic hypoglycemia
oral dextrose gel
late preterm
small for gestational age
large for gestational age
children of diabetic mothers
url https://www.frontiersin.org/articles/10.3389/fped.2025.1591567/full
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