LOW DOSE INSULIN DELIVERY TO EXTREMELY LOW BIRTH WEIGHT INFANTS

Wake Forest University, Winston Salem NC

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Abstract

Premature infants often have high blood sugars in the first several weeks of life. The first step in the management of infant with high blood sugars is to decrease the amount of dextrose (sugar) they are receiving through intravenous fluids to the minimal amount needed to supply adequate calories to maintain weight and energy stores. However, if the high blood sugar levels persist, premature infants are treated with a continuous insulin infusion. In our laboratory, we have shown that insulin binds or sticks to the infusion tubing used to deliver it. It can take up to 24 hours to actually deliver the amount of insulin that is prescribed for the infant, causing a delay in the normalization of blood sugars. Insulin has been shown to help premature infants use the sugar calories provided and to achieve better weight gain. We have also shown that if the tubing is flushed with a higher concentration of insulin, delivery of the prescribed amount of insulin occurs much faster. This research study is to determine if flushing the infusion tubing with a higher concentration of insulin, prior to beginning a standard insulin infusion will result in more effective insulin delivery compared to the conventional method of insulin delivery. We will compare the amount of time needed to lower blood sugars to normal levels in both groups.