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Persistent hyperglycaemia in preemies may alter body composition, neurodevelopment

30 Jul 2020
Premature babies are prone to birth-related complications, with effects running well into their lives if they do not first succumb to death.

In premature infants, prolonged hyperglycaemia may lead to lower fat mass and worse neurodevelopmental outcomes in the long run, a recent study has found.

Researchers accessed prospective data from 97 premature infants (born <32 weeks of gestation, 51.5 percent male). Hyperglycaemia was defined as blood glucose >150 mg/dL. The outcome of body composition was measured at 4 months’ postmenstrual age (PMA), while neurodevelopmental outcomes were assessed at 12 months’ PMA.

Almost half of the participants (48.5 percent) experienced hyperglycaemia; 27 percent had it for 1–4 days, and 21 percent experienced prolonged hyperglycaemia lasting for ≥5 days. Eighty-three infants had their body compositions measured between 32 and 42 weeks’ PMA, while 76 underwent the same measurement at 4 months’ PMA.

The Bayley Scales of Infant Development III (BSID-III) was used for the assessment of neurodevelopment, and at 12 months’ PMA was administered to 66 participants.

Prolonged hyperglycaemia showed a significant but inverse correlation with the z-scores for fat mass (p=0.007) and fat-free mass (p=0.003) at discharge, but only fat-free mass remained significant at 4 months’ PMA. However, adjusting for first-week nutrient intake attenuated all interactions.

Similarly, hyperglycaemia for ≥5 days was inversely correlated with BSID-III scores in the domain of cognition (p<0.02), language (p<0.02), and motor (p<0.01). Accounting for first-week nutrient intake again diminished these associations.

“These relationships appear to be mediated by decreased nutrient intake during the first week of life rather than the severity of illness,” researchers said. “Randomized trials of insulin therapy combined with nutritional adjustments are needed to determine the optimal strategy to improve long-term growth and neurodevelopmental outcomes.”

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Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Roshini Claire Anthony, 13 Nov 2020

Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Pearl Toh, 5 days ago
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Elvira Manzano, 17 Nov 2020
Invasive fungal infections, particularly those caused by Candida species, are common in hospitalized, immunocompromised, or critically ill patients and are associated with considerable morbidity and mortality.