Relationships Between Early Nutrition and Blood Glucose Concentrations in Very Preterm Infants.

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dc.contributor.author Tottman, Anna en
dc.contributor.author Bloomfield, Francis en
dc.contributor.author Cormack, Barbara en
dc.contributor.author Harding, Jane en
dc.contributor.author Mohd Slim, M Atif en
dc.contributor.author Weston, Abigail F en
dc.contributor.author Alsweiler, Jane en
dc.date.accessioned 2018-10-22T20:37:31Z en
dc.date.issued 2018-06 en
dc.identifier.issn 0277-2116 en
dc.identifier.uri http://hdl.handle.net/2292/43070 en
dc.description.abstract OBJECTIVES:The aim of the study was to determine whether changes to early nutrition are associated with levels of glycemia in very preterm infants. METHODS:A retrospective, observational study of infants <1500 g or <30 weeks' gestation admitted to Neonatal Intensive Care, National Women's Hospital, New Zealand, before (Old Protocol) and after (New Protocol) a change in nutritional protocol. Nutritional intakes were calculated and averaged by day for postnatal days 1 to 7 (week 1) and 1 to 28 (month 1). Relationships between glycemia measures, macronutrient intakes, and achievement of 10% enteral feeds (≥10% total intake) were explored using logistic regression. RESULTS:Old Protocol (n = 190) and New Protocol (n = 267) groups had similar baseline characteristics. In week 1, New Protocol infants received more protein, less fat, and carbohydrate, had lower mean blood glucose concentrations (BGCs) (mean ± SD 4.9 ± 1.2 vs 5.6 ± 1.4 mmoll/L, P < 0.0001), less hyperglycemia (BGC > 8.5 mmol/L, 71 [27%] vs 80 [42%], P = 0.0005), but similar hypoglycemia (BGC < 2.6). In month 1, New Protocol infants also had less hyperglycemia (105 [39%] vs 96 [51%], P = 0.02) and lower mean BGC (5.0 ± 1.1 vs 5.5 ± 1.1 mmol/L, P < 0.0001), but insulin usage was similar. After adjustment for birth weight z score and gestational age, hyperglycemia was significantly associated with week 1 intakes (g · kg · day) of protein (odds ratio [95% confidence intervals] 0.47 [0.23-0.79], P = 0.004), fat (0.54 [0.40-0.74], P < 0.0001), and carbohydrate (1.25 [1.09-1.44], P < 0.0001). These relationships were similar for month 1. Each additional day to achieve 10% enteral feeds was associated with increased odds of hypoglycemia (1.09 [1.00-1.18], P = 0.04) and hyperglycemia (1.16 [1.06-1.28], P = 0.002). CONCLUSIONS:In very preterm infants, macronutrient balance and small, early enteral feeds may assist glycemic control. en
dc.format.medium Print en
dc.language eng en
dc.relation.ispartofseries Journal of pediatric gastroenterology and nutrition en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Humans en
dc.subject Infant, Premature, Diseases en
dc.subject Hyperglycemia en
dc.subject Hypoglycemia en
dc.subject Blood Glucose en
dc.subject Treatment Outcome en
dc.subject Clinical Protocols en
dc.subject Enteral Nutrition en
dc.subject Parenteral Nutrition en
dc.subject Logistic Models en
dc.subject Retrospective Studies en
dc.subject Infant, Newborn en
dc.subject Infant, Premature en
dc.subject Infant Care en
dc.subject Female en
dc.subject Male en
dc.subject Biomarkers en
dc.subject Nutrients en
dc.title Relationships Between Early Nutrition and Blood Glucose Concentrations in Very Preterm Infants. en
dc.type Journal Article en
dc.identifier.doi 10.1097/mpg.0000000000001929 en
pubs.issue 6 en
pubs.begin-page 960 en
pubs.volume 66 en
dc.rights.holder Copyright: The author en
dc.identifier.pmid 29481441 en
pubs.end-page 966 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype Journal Article en
pubs.subtype Observational Study en
pubs.elements-id 727285 en
pubs.org-id Liggins Institute en
pubs.org-id LiFePATH en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Paediatrics Child & Youth Hlth en
dc.identifier.eissn 1536-4801 en
pubs.record-created-at-source-date 2018-02-27 en
pubs.dimensions-id 29481441 en


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