Glucose Gel as a Treatment Strategy for Transient Neonatal Hypoglycemia

Katherine M. Newnam, Marissa Bunch, Sheila M Gephart

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Transient asymptomatic neonatal hypoglycemia (TANH) is common as infants transition from their mother's energy stores to their own. There is little evidence supporting the blood glucose threshold that indicates a need for treatment although sustained hypoglycemia has been correlated with negative neurodevelopmental consequences. Treatment of TANH includes a stepwise approach from supplemental enteral feedings, buccal glucose gel, intravenous dextrose infusion, and/or transfer to special care units including neonatal intensive care units. Purpose: The purpose of this evidence-based practice brief is to review current evidence on 40% buccal glucose gel administration as a treatment strategy for TANH. Methods/Search Strategy: CINAHL, Cochrane, Google Scholar, and PubMed were searched using the key words and restricted to English language over the last 7 years. Findings/Results: The use of buccal dextrose gel for TANH may reduce neonatal intensive care unit admissions, reduce hospital length of stay and cost, support the mother-infant dyad through reduced separation, support exclusive breastfeeding, and improve parental satisfaction without adverse neurodevelopmental consequences. Implications for Practice: Timely collection of blood glucose levels following intervention is critical to support clinical decisions. Clinicians should offer family education regarding the rationale for serial glucose monitoring and treatment indications including buccal glucose administration. Clinical protocols can be revised to include use of buccal dextrose gel. Implications for Research: There is a need for rigorous long-term studies comparing treatment thresholds and neurodevelopmental outcomes among various treatment strategies for TANH.

Original languageEnglish (US)
Pages (from-to)470-477
Number of pages8
JournalAdvances in Neonatal Care
Volume17
Issue number6
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Fingerprint

Hypoglycemia
Gels
Cheek
Glucose
Neonatal Intensive Care Units
Therapeutics
Blood Glucose
Buccal Administration
Length of Stay
Clinical Decision Support Systems
Mothers
Hospital Costs
Evidence-Based Practice
Enteral Nutrition
Clinical Protocols
Breast Feeding
PubMed
Intravenous Infusions
Language
Education

Keywords

  • glucose gel
  • hypoglycemia
  • hypoglycemia of the newborn
  • neonatal hypoglycemia
  • neonatal hypoglycemia treatment
  • transient neonatal hypoglycemia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Glucose Gel as a Treatment Strategy for Transient Neonatal Hypoglycemia. / Newnam, Katherine M.; Bunch, Marissa; Gephart, Sheila M.

In: Advances in Neonatal Care, Vol. 17, No. 6, 01.12.2017, p. 470-477.

Research output: Contribution to journalArticle

Newnam, Katherine M. ; Bunch, Marissa ; Gephart, Sheila M. / Glucose Gel as a Treatment Strategy for Transient Neonatal Hypoglycemia. In: Advances in Neonatal Care. 2017 ; Vol. 17, No. 6. pp. 470-477.
@article{2b1e0fb767bc415cab46580a2844b88a,
title = "Glucose Gel as a Treatment Strategy for Transient Neonatal Hypoglycemia",
abstract = "Background: Transient asymptomatic neonatal hypoglycemia (TANH) is common as infants transition from their mother's energy stores to their own. There is little evidence supporting the blood glucose threshold that indicates a need for treatment although sustained hypoglycemia has been correlated with negative neurodevelopmental consequences. Treatment of TANH includes a stepwise approach from supplemental enteral feedings, buccal glucose gel, intravenous dextrose infusion, and/or transfer to special care units including neonatal intensive care units. Purpose: The purpose of this evidence-based practice brief is to review current evidence on 40{\%} buccal glucose gel administration as a treatment strategy for TANH. Methods/Search Strategy: CINAHL, Cochrane, Google Scholar, and PubMed were searched using the key words and restricted to English language over the last 7 years. Findings/Results: The use of buccal dextrose gel for TANH may reduce neonatal intensive care unit admissions, reduce hospital length of stay and cost, support the mother-infant dyad through reduced separation, support exclusive breastfeeding, and improve parental satisfaction without adverse neurodevelopmental consequences. Implications for Practice: Timely collection of blood glucose levels following intervention is critical to support clinical decisions. Clinicians should offer family education regarding the rationale for serial glucose monitoring and treatment indications including buccal glucose administration. Clinical protocols can be revised to include use of buccal dextrose gel. Implications for Research: There is a need for rigorous long-term studies comparing treatment thresholds and neurodevelopmental outcomes among various treatment strategies for TANH.",
keywords = "glucose gel, hypoglycemia, hypoglycemia of the newborn, neonatal hypoglycemia, neonatal hypoglycemia treatment, transient neonatal hypoglycemia",
author = "Newnam, {Katherine M.} and Marissa Bunch and Gephart, {Sheila M}",
year = "2017",
month = "12",
day = "1",
doi = "10.1097/ANC.0000000000000426",
language = "English (US)",
volume = "17",
pages = "470--477",
journal = "Advances in Neonatal Care",
issn = "1536-0903",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Glucose Gel as a Treatment Strategy for Transient Neonatal Hypoglycemia

AU - Newnam, Katherine M.

AU - Bunch, Marissa

AU - Gephart, Sheila M

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background: Transient asymptomatic neonatal hypoglycemia (TANH) is common as infants transition from their mother's energy stores to their own. There is little evidence supporting the blood glucose threshold that indicates a need for treatment although sustained hypoglycemia has been correlated with negative neurodevelopmental consequences. Treatment of TANH includes a stepwise approach from supplemental enteral feedings, buccal glucose gel, intravenous dextrose infusion, and/or transfer to special care units including neonatal intensive care units. Purpose: The purpose of this evidence-based practice brief is to review current evidence on 40% buccal glucose gel administration as a treatment strategy for TANH. Methods/Search Strategy: CINAHL, Cochrane, Google Scholar, and PubMed were searched using the key words and restricted to English language over the last 7 years. Findings/Results: The use of buccal dextrose gel for TANH may reduce neonatal intensive care unit admissions, reduce hospital length of stay and cost, support the mother-infant dyad through reduced separation, support exclusive breastfeeding, and improve parental satisfaction without adverse neurodevelopmental consequences. Implications for Practice: Timely collection of blood glucose levels following intervention is critical to support clinical decisions. Clinicians should offer family education regarding the rationale for serial glucose monitoring and treatment indications including buccal glucose administration. Clinical protocols can be revised to include use of buccal dextrose gel. Implications for Research: There is a need for rigorous long-term studies comparing treatment thresholds and neurodevelopmental outcomes among various treatment strategies for TANH.

AB - Background: Transient asymptomatic neonatal hypoglycemia (TANH) is common as infants transition from their mother's energy stores to their own. There is little evidence supporting the blood glucose threshold that indicates a need for treatment although sustained hypoglycemia has been correlated with negative neurodevelopmental consequences. Treatment of TANH includes a stepwise approach from supplemental enteral feedings, buccal glucose gel, intravenous dextrose infusion, and/or transfer to special care units including neonatal intensive care units. Purpose: The purpose of this evidence-based practice brief is to review current evidence on 40% buccal glucose gel administration as a treatment strategy for TANH. Methods/Search Strategy: CINAHL, Cochrane, Google Scholar, and PubMed were searched using the key words and restricted to English language over the last 7 years. Findings/Results: The use of buccal dextrose gel for TANH may reduce neonatal intensive care unit admissions, reduce hospital length of stay and cost, support the mother-infant dyad through reduced separation, support exclusive breastfeeding, and improve parental satisfaction without adverse neurodevelopmental consequences. Implications for Practice: Timely collection of blood glucose levels following intervention is critical to support clinical decisions. Clinicians should offer family education regarding the rationale for serial glucose monitoring and treatment indications including buccal glucose administration. Clinical protocols can be revised to include use of buccal dextrose gel. Implications for Research: There is a need for rigorous long-term studies comparing treatment thresholds and neurodevelopmental outcomes among various treatment strategies for TANH.

KW - glucose gel

KW - hypoglycemia

KW - hypoglycemia of the newborn

KW - neonatal hypoglycemia

KW - neonatal hypoglycemia treatment

KW - transient neonatal hypoglycemia

UR - http://www.scopus.com/inward/record.url?scp=85037718670&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85037718670&partnerID=8YFLogxK

U2 - 10.1097/ANC.0000000000000426

DO - 10.1097/ANC.0000000000000426

M3 - Article

C2 - 28857766

AN - SCOPUS:85037718670

VL - 17

SP - 470

EP - 477

JO - Advances in Neonatal Care

JF - Advances in Neonatal Care

SN - 1536-0903

IS - 6

ER -