The Impact of Implementation of Oral Dextrose Gel on the Incidence of Multiple Hypoglycemia Events in the Well Newborn Nursery

Abstract

Objective: Evaluate the impact of 40% oral dextrose gel (DG) for management of neonatal hypoglycemia (NH) on the incidence of multiple hypoglycemic events in the well-baby nursery. Study Design: A retrospective chart review of 738 at-risk infants in 2 cohorts before (Cohort 1) and after (Cohort 2) DG implementation. Primary outcome was the incidence of ≥2 hypoglycemic episodes. Secondary outcomes were median number of hypoglycemia events per infant, lowest median glucose level, and incidence of NICU admission. Results: There were 384 and 354 at-risk newborns in Cohorts 1 & 2. Incidence of multiple hypoglycemia episodes decreased following DG implementation [62(42.5%) vs 29(25.9%), p=0.0058]. Median (range) number of hypoglycemic episodes per infant also decreased [1 (1-6) vs 1 (1-5), p=0.046]. There were no differences in lowest glucose level [37 (14-45) vs 37 (10-45), p=0.31] or NICU admission rate [31 (21.2%) vs 21 (18.8%), p=0.62]. Conclusions:Implementation of DG lowers the incidence of subsequent multiple hypoglycemia events.