Tiny, premature infants did just fine when given an intravenous feeding containing far less glucose than the amount usually given. Researchers found that the 5-day-old preemies were able to make their own glucose using amino acids and fats added to the feeding solution as glucose replacements. This means the amount of glucose in the intravenous solution could safely be reduced, which would cut the risk of high blood glucose levels without increasing the risk of glucose levels that were too low. Healthy, full-term babies are able to break down their glycogen, fat, and protein stores to make glucose. But very premature infants are born before these stores develop. So they are given extra glucose to prevent a brain-damaging drop in their blood glucose levels and to meet their energy needs. That often produces high blood sugar, however. When this happens, they lose precious sugar, water, and salts through the urine, putting them at risk for dehydration and electrolyte imbalances. Excess glucose can also affect the amount of carbon dioxide these infants produce, exacerbating problems for those with lung disorders. To test metabolic capacity, researchers cut the glucose infusion rate by 75 percent in 20 very premature infants, while providing amino acids and a fat emulsion. Despite this reduction, blood glucose levels remained in the normal range for all infants throughout the 8- to 12-hour study period. Tracers showed that the majority of the glucose the infants produced was derived from the fat and amino acids in the intravenous solution, confirming that they could use their own metabolic pathway to make glucose when needed.

Children’s Nutrition Research Center at Baylor College of Medicine, Houston, TX
Agneta Sunehag, (713) 798-6725, asunehag@bcm.tmc.edu