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Insulin for Treatment of Neonatal Hyperglycemia in Premature Infants: Prevalence over Time and Association with Outcomes.

Publication ,  Journal Article
Titchiner, D; Hornik, C; Benjamin, R; Tolia, V; Smith, PB; Greenberg, RG
Published in: Am J Perinatol
December 21, 2022

OBJECTIVE:  Our objective was to determine the prevalence of insulin treatment in premature infants with hyperglycemia and evaluate the association of length of treatment with outcomes. STUDY DESIGN:  The study included cohort of 29,974 infants 22 to 32 weeks gestational age (GA) admitted to over 300 neonatal intensive care unit (NICU) from 1997 to 2018 and diagnosed with hyperglycemia. RESULTS:  Use of insulin significantly decreased during the study period (p = 0.002) among studied NICUs. The percentage of hyperglycemic infants exposed to insulin ranged from 0 to 81%. Infants who received insulin were more likely to have lower GA, birth weight, 5-minute Apgar score, longer duration of stay, and require mechanical ventilation. After adjustment for GA, infants requiring insulin for >14 days were more likely to have treated retinopathy of prematurity (ROP) and develop chronic lung disease (CLD). Insulin treatment of 1 to 7 days had increased odds of death, death/ROP, and death/CLD compared with no exposure. CONCLUSION:  Insulin use decreased over time, and differing durations of use were associated with adverse outcomes. KEY POINTS: · Insulin use decreased over time.. · There is a temporal relation between the duration of treatment and adverse outcomes.. · Further studies are needed to determine the efficacy and safety of insulin use..

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Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

December 21, 2022

Location

United States

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • 4204 Midwifery
  • 3215 Reproductive medicine
  • 3213 Paediatrics
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences
 

Citation

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Titchiner, D., Hornik, C., Benjamin, R., Tolia, V., Smith, P. B., & Greenberg, R. G. (2022). Insulin for Treatment of Neonatal Hyperglycemia in Premature Infants: Prevalence over Time and Association with Outcomes. Am J Perinatol. https://doi.org/10.1055/a-1976-2142
Titchiner, Daniela, Chi Hornik, Robert Benjamin, Veeral Tolia, P Brian Smith, and Rachel G. Greenberg. “Insulin for Treatment of Neonatal Hyperglycemia in Premature Infants: Prevalence over Time and Association with Outcomes.Am J Perinatol, December 21, 2022. https://doi.org/10.1055/a-1976-2142.
Titchiner D, Hornik C, Benjamin R, Tolia V, Smith PB, Greenberg RG. Insulin for Treatment of Neonatal Hyperglycemia in Premature Infants: Prevalence over Time and Association with Outcomes. Am J Perinatol. 2022 Dec 21;
Titchiner, Daniela, et al. “Insulin for Treatment of Neonatal Hyperglycemia in Premature Infants: Prevalence over Time and Association with Outcomes.Am J Perinatol, Dec. 2022. Pubmed, doi:10.1055/a-1976-2142.
Titchiner D, Hornik C, Benjamin R, Tolia V, Smith PB, Greenberg RG. Insulin for Treatment of Neonatal Hyperglycemia in Premature Infants: Prevalence over Time and Association with Outcomes. Am J Perinatol. 2022 Dec 21;
Journal cover image

Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

December 21, 2022

Location

United States

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • 4204 Midwifery
  • 3215 Reproductive medicine
  • 3213 Paediatrics
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences