OLEH:
1110017004
“Control Group
Infants who were randomly assigned to the controlgroup received
standard care in which the physicianwho was responsible for
clinical care reviewedglucose levels that were greater than 10
mmol perliter (180 mg per deciliter) or less than 2.6 mmol(47 mg
per deciliter). The physician would determinewhether the rate of
infusion of dextroseshould be reduced or increased or if insulin
therapyshould be initiated. Insulin was initiated onlyafter two
glucose levels were greater than 10 mmolper liter with the use of a
sliding scale and an initialdose of 0.05 U per kilogram per hour”
“Control Group
Infants who were randomly assigned to the control group received
standard care in which the physician who was responsible for
clinical care reviewed glucose levels that were greater than 10
mmol per liter (180 mg per deciliter) or less than 2.6 mmol (47 mg
per deciliter). The physician would determine whether the rate of
infusion of dextrose should be reduced or increased or if insulin
therapy should be initiated. Insulin was initiated only after two
glucose levels were greater than 10 mmol per liter with the use of
a sliding scale and an initial dose of 0.05 U per kilogram per
hour”
”Results
As compared with infants in the control group, infants in the early-
insulin group had lower mean (±SD) glucose levels (6.2±1.4 vs.
6.7±2.2 mmol per liter [112±25 vs.121±40 mg per deciliter], P =
0.007). Fewer infants in the early-insulin group had
hyperglycemia for more than 10% of the first week of life (21% vs.
33%, P = 0.008).The early-insulin group had significantly more
carbohydrate infused (51±13 vs.43±10 kcal per kilogram per day,
P<0.001) and less weight loss in the first week(standard-deviation
score for change in weight, −0.55±0.52 vs. −0.70±0.47; P =
0.006).More infants in the early-insulin group had episodes of
hypoglycemia (defined as ablood glucose level of <2.6 mmol per
liter [47 mg per deciliter] for >1 hour) (29% inthe early-insulin
group vs. 17% in the control group, P = 0.005), and the increase
inhypoglycemia was significant in infants with birth weights of
more than 1 kg.There were no differences in the intention-to-treat
analyses for the primary outcome(mortality at the expected date of
delivery) and the secondary outcome (morbidity).In the intention-
to-treat analysis, mortality at 28 days was higher in the
earlyinsulingroup than in the control group (P = 0.04).”