{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:21:14Z","timestamp":1790706074266,"version":"4.1.0"},"reference-count":52,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                  <jats:p>Hypoglycemia occurs in 5% to 15% of neonates in the first few days. A significant proportion requires admission for intravenous fluids. Dextrose gel may reduce admissions and mother-infant separation. We aimed to study the utility of dextrose gel in reducing the need for intravenous fluids.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This stratified randomized control trial included at-risk infants with asymptomatic hypoglycemia. Study populations were stratified into 3 categories: small for gestational age (SGA) and intrauterine growth-restriction (IUGR), infants of diabetic mothers (IDM) and large for gestational age (LGA), and late preterm (LPT) neonates. Intervention group received dextrose gel followed by breastfeeding, and the control group (CG) received only breastfeeding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Among 629 at-risk infants, 291 (46%) developed asymptomatic hypoglycemia; 147 (50.4%) in the dextrose gel group (DGG) and 144 (49.6%) in CG. There were 97, 98, and 96 infants in SGA\/IUGR, IDM\/LGA, and LPT categories, respectively. Treatment failure in the DGG was 17 (11.5%) compared to 58 (40.2%) in CG, with a risk ratio of 0.28 (95% confidence interval [CI]: 0.17\u20130.46; P &amp;lt; .001). Treatment failure was significantly less in DGG in all 3 categories: SGA\/IUGR, IDM\/LGA, and LPT with a risk ratio of 0.29 (95% CI:0.13-0.67), 0.31 (95% CI:0.14\u20130.66) and 0.24 (95% CI:0.09\u20130.66), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Dextrose gel reduces the need for intravenous fluids in at-risk neonates with asymptomatic hypoglycemia in the first 48 hours of life.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2021-050733","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T08:08:30Z","timestamp":1652861310000},"source":"Crossref","is-referenced-by-count":27,"title":["Dextrose Gel for Neonates at Risk With Asymptomatic Hypoglycemia: A Randomized Clinical Trial"],"prefix":"10.1542","volume":"149","author":[{"given":"Kirti","family":"Gupta","sequence":"first","affiliation":[{"name":"Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash","family":"Amboiram","sequence":"additional","affiliation":[{"name":"Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umamaheswari","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"C","sequence":"additional","affiliation":[{"name":"Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thangaraj","family":"Abiramalatha","sequence":"additional","affiliation":[{"name":"Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usha","family":"Devi","sequence":"additional","affiliation":[{"name":"Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"issue":"5","key":"2023110214011377500_B1","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.jpeds.2012.05.022","article-title":"Incidence of neonatal hypoglycemia in babies identified as at risk","volume":"161","author":"Harris","year":"2012","journal-title":"J Pediatr"},{"issue":"5","key":"2023110214011377500_B2","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jpeds.2009.06.044","article-title":"Knowledge gaps and research needs for understanding and treating neonatal hypoglycemia: workshop report from Eunice Kennedy Shriver National Institute of Child Health and Human Development","volume":"155","author":"Hay","year":"2009","journal-title":"J Pediatr"},{"issue":"2","key":"2023110214011377500_B3","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1159\/000203337","article-title":"Hypoglycemia rates in the first days of life among term infants born to diabetic mothers","volume":"96","author":"Maayan-Metzger","year":"2009","journal-title":"Neonatology"},{"key":"2023110214011377500_B4","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.pediatrneurol.2017.05.028","article-title":"Neurodevelopmental outcome of asymptomatic hypoglycemia compared with symptomatic hypoglycemia and euglycemia in high-risk neonates","volume":"74","author":"Mahajan","year":"2017","journal-title":"Pediatr Neurol"},{"issue":"10","key":"2023110214011377500_B5","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1007\/s10654-018-0425-5","article-title":"Moderate neonatal hypoglycemia and adverse neurological development at 2-6 years of age","volume":"33","author":"Wickstr\u00f6m","year":"2018","journal-title":"Eur J Epidemiol"},{"issue":"1","key":"2023110214011377500_B6","doi-asserted-by":"crossref","first-page":"8132","DOI":"10.1038\/s41598-019-44609-1","article-title":"Factors influencing glycaemic stability after neonatal hypoglycaemia and relationship to neurodevelopmental outcome","volume":"9","author":"Burakevych","year":"2019","journal-title":"Sci Rep"},{"issue":"2","key":"2023110214011377500_B7","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1159\/000492859","article-title":"Neonatal glycaemia and neurodevelopmental outcomes: a systematic review and meta-analysis","volume":"115","author":"Shah","year":"2019","journal-title":"Neonatology"},{"issue":"6659","key":"2023110214011377500_B8","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1136\/bmj.297.6659.1304","article-title":"Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia","volume":"297","author":"Lucas","year":"1988","journal-title":"BMJ"},{"issue":"4","key":"2023110214011377500_B9","doi-asserted-by":"crossref","first-page":"360","DOI":"10.5301\/jva.5000558","article-title":"Peripheral intravenous cannulation: complication rates in the neonatal population: a multicenter observational study","volume":"17","author":"Legemaat","year":"2016","journal-title":"J Vasc Access"},{"issue":"6659","key":"2023110214011377500_B10","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1136\/bmj.297.6659.1304","article-title":"Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia","volume":"297","author":"Lucas","year":"1988","journal-title":"BMJ"},{"issue":"5","key":"2023110214011377500_B11","first-page":"CD011027","article-title":"Oral dextrose gel for the treatment of hypoglycaemia in newborn infants","author":"Weston","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"2023110214011377500_B12","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.18203\/2349-3291.ijcp20182567","article-title":"Venous access in neonates: our experience","volume":"5","author":"Sharma","year":"2018","journal-title":"Int J Contemp Pediatrics"},{"issue":"5","key":"2023110214011377500_B13","doi-asserted-by":"crossref","first-page":"F467","DOI":"10.1136\/archdischild-2013-304580","article-title":"Blood glucose homeostasis in the first 24 h of life","volume":"98","author":"Juthani","year":"2013","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"5","key":"2023110214011377500_B14","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1089\/bfm.2021.29178.new","article-title":"ABM clinical protocol #1: guidelines for glucose monitoring and treatment of hypoglycemia in term and late preterm neonates, revised 2021","volume":"16","author":"Wight","year":"2021","journal-title":"Breastfeed Med"},{"issue":"3","key":"2023110214011377500_B15","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1542\/peds.2010-3851","article-title":"Postnatal glucose homeostasis in late-preterm and term infants","volume":"127","author":"Adamkin","year":"2011","journal-title":"Pediatrics"},{"key":"2023110214011377500_B16","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/1471-2431-13-59","article-title":"A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants","volume":"13","author":"Fenton","year":"2013","journal-title":"BMC Pediatr"},{"key":"2023110214011377500_B17","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4137\/CMPed.S40070","article-title":"Intrauterine growth restriction: antenatal and postnatal aspects","volume":"10","author":"Sharma","year":"2016","journal-title":"Clin Med Insights Pediatr"},{"key":"2023110214011377500_B18","volume-title":"Oral Glucose Gel for Neonatal Hypoglycemia: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines","author":"Paylyk-Colwell","year":"2018"},{"issue":"2","key":"2023110214011377500_B19","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.jpeds.2015.03.057","article-title":"Recommendations from the pediatric endocrine society for evaluation and management of persistent hypoglycemia in neonates, infants, and children","volume":"167","author":"Thornton","year":"2015","journal-title":"J Pediatr"},{"issue":"12","key":"2023110214011377500_B20","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1038\/nrendo.2015.188","article-title":"Paediatric endocrinology: defining treatment thresholds for neonatal hypoglycaemia-how low is too low?","volume":"11","author":"Greenhill","year":"2015","journal-title":"Nat Rev Endocrinol"},{"issue":"1","key":"2023110214011377500_B21","doi-asserted-by":"crossref","first-page":"10","DOI":"10.4103\/2249-4847.128718","article-title":"Dextrose gel is superior to feeding alone in neonatal hypoglycemia","volume":"3","author":"Mosalli","year":"2014","journal-title":"J Clin Neonatol"},{"issue":"3","key":"2023110214011377500_B22","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1136\/eb-2016-102466","article-title":"The effectiveness of oral dextrose gel for the treatment of neonatal hypoglycaemia remains unclear","volume":"20","author":"Chandrasekharan","year":"2017","journal-title":"Evid Based Nurs"},{"issue":"9910","key":"2023110214011377500_B23","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1016\/S0140-6736(13)61645-1","article-title":"Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial","volume":"382","author":"Harris","year":"2013","journal-title":"Lancet"},{"key":"2023110214011377500_B24","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1186\/s12887-015-0440-6","article-title":"Randomised trial of neonatal hypoglycaemia prevention with oral dextrose gel (hPOD): study protocol","volume":"15","author":"Harding","year":"2015","journal-title":"BMC Pediatr"},{"issue":"3","key":"2023110214011377500_B25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000448511","article-title":"Oral dextrose gel reduces the need for intravenous dextrose therapy in neonatal hypoglycemia","volume":"1","author":"Rawat","year":"2016","journal-title":"Biomed Hub"},{"issue":"5","key":"2023110214011377500_B26","doi-asserted-by":"crossref","first-page":"F382","DOI":"10.1136\/archdischild-2012-303422","article-title":"Definition of neonatal hypoglycaemia: time for a rethink?","volume":"98","author":"Hawdon","year":"2013","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"5","key":"2023110214011377500_B27","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.earlhumdev.2010.05.002","article-title":"Describing hypoglycemia--definition or operational threshold?","volume":"86","author":"Rozance","year":"2010","journal-title":"Early Hum Dev"},{"issue":"3","key":"2023110214011377500_B28","doi-asserted-by":"crossref","first-page":"e91","DOI":"10.1542\/neo.15-3-e91","article-title":"Neonatal hypoglycemia: are evidence-based clinical guidelines achievable?","volume":"15","author":"Hawdon","year":"2014","journal-title":"NeoReviews"},{"issue":"1","key":"2023110214011377500_B29","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1038\/jp.2015.125","article-title":"Neonatal hypoglycemia: is 60 the new 40? the questions remain the same","volume":"36","author":"Adamkin","year":"2016","journal-title":"J Perinatol"},{"issue":"6","key":"2023110214011377500_B30","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1007\/s13312-017-1051-0","article-title":"Screening for hypoglycemia in exclusively breastfed high-risk neonates","volume":"54","author":"Singh","year":"2017","journal-title":"Indian Pediatr"},{"issue":"6","key":"2023110214011377500_B31","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1136\/archdischild-2015-308336","article-title":"What is a normal blood glucose?","volume":"101","author":"G\u00fcemes","year":"2016","journal-title":"Arch Dis Child"},{"issue":"10","key":"2023110214011377500_B32","doi-asserted-by":"crossref","first-page":"e1002155","DOI":"10.1371\/journal.pmed.1002155","article-title":"Prophylactic oral dextrose gel for newborn babies at risk of neonatal hypoglycaemia: a randomised controlled dose-finding trial (the pre-hPOD study)","volume":"13","author":"Hegarty","year":"2016","journal-title":"PLoS Med"},{"issue":"2_Meeting Abstract","key":"2023110214011377500_B33","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1542\/peds.144.2MA7.673","article-title":"Oral glucose gel for neonatal hypoglycemia- a single hospital study","volume":"144","author":"Romald","year":"2019","journal-title":"Pediatrics"},{"issue":"1","key":"2023110214011377500_B34","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1136\/archdischild-2018-316430","article-title":"Incorporating dextrose gel and feeding in the treatment of neonatal hypoglycaemia","volume":"105","author":"Gregory","year":"2020","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"1","key":"2023110214011377500_B35","doi-asserted-by":"crossref","first-page":"e1003411","DOI":"10.1371\/journal.pmed.1003411","article-title":"Evaluation of oral dextrose gel for prevention of neonatal hypoglycemia (hPOD): a multicenter, double-blind randomized controlled trial","volume":"18","author":"Harding","year":"2021","journal-title":"PLoS Med"},{"issue":"5","key":"2023110214011377500_B36","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1080\/14767058.2017.1391781","article-title":"Early neonatal hypoglycemia: incidence of and risk factors. a cohort study using universal point of care screening","volume":"32","author":"Bromiker","year":"2019","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2023110214011377500_B37","doi-asserted-by":"crossref","first-page":"1179551420928326","DOI":"10.1177\/1179551420928326","article-title":"Galenic preparation of 40% dextrose gel: a new approach to the management of neonatal hypoglycemia","volume":"13","author":"Rivano","year":"2020","journal-title":"Clin Med Insights Endocrinol Diabetes"},{"issue":"5","key":"2023110214011377500_B38","first-page":"CD012152","article-title":"Oral dextrose gel to prevent hypoglycaemia in at-risk neonates","volume":"5","author":"Edwards","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"2023110214011377500_B39","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1097\/ANC.0000000000000426","article-title":"Glucose gel as a treatment strategy for transient neonatal hypoglycemia","volume":"17","author":"Newnam","year":"2017","journal-title":"Adv Neonatal Care"},{"issue":"10","key":"2023110214011377500_B40","first-page":"e1002155","article-title":"Prophylactic oral dextrose gel for newborn babies at risk of neonatal hypoglycaemia","volume":"13","author":"Hegarty","year":"2016"},{"key":"2023110214011377500_B41","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.jpeds.2017.06.034","article-title":"What happens to blood glucose concentrations after oral treatment for neonatal hypoglycemia?","volume":"190","author":"Harris","year":"2017","journal-title":"J Pediatr"},{"issue":"1","key":"2023110214011377500_B42","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s40274-020-6985-0","article-title":"Dextrose gel cost effective in neonates at risk of hypoglycaemia","volume":"858","year":"2020","journal-title":"Pharmaco Economics outcomes news"},{"issue":"3","key":"2023110214011377500_B43","doi-asserted-by":"crossref","first-page":"192","DOI":"10.4103\/ija.IJA_143_17","article-title":"Regulatory requirements for clinical trials in India: what academicians need to know","volume":"61","author":"Gogtay","year":"2017","journal-title":"Indian J Anaesth"},{"issue":"1","key":"2023110214011377500_B44","article-title":"A brief review of hyperinsulinism in small for gestational age infants","volume":"5","author":"Kumar","year":"2017","journal-title":"Journal of medical science and clinical research"},{"key":"2023110214011377500_B45","article-title":"Neonatal Hypoglycemia","volume-title":"StatPearls","author":"Abramowski","year":"2020"},{"key":"2023110214011377500_B46","doi-asserted-by":"crossref","DOI":"10.1136\/archdischild-2019-epa.327","article-title":"GP268 Impact of the use of oral dextrose gel for neonatal hypoglycaemia and admission rates to neonatal units: a systematic review and meta-analysis","volume-title":"Abstracts","author":"Egan","year":"2019"},{"key":"2023110214011377500_B47","unstructured":"World Health Organization\n          . Every newborn action plan. Available at: https:\/\/www.who.int\/maternal_child_ adolescent\/newborns\/every-newborn\/en\/. Accessed August 27, 2021"},{"issue":"3","key":"2023110214011377500_B48","doi-asserted-by":"crossref","first-page":"e827","DOI":"10.1542\/peds.2011-3552","article-title":"Breastfeeding and the use of human milk","volume":"129","author":"Section on Breastfeeding","year":"2012","journal-title":"Pediatrics"},{"issue":"4","key":"2023110214011377500_B49","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1097\/MPG.0b013e3182a3af0a","article-title":"Donor human milk for preterm infants: current evidence and research directions","volume":"57","author":"Arslanoglu","year":"2013","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"7","key":"2023110214011377500_B50","first-page":"CD002971","article-title":"Formula versus donor breast milk for feeding preterm or low birth weight infants","volume":"7","author":"Quigley","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"2023110214011377500_B51","doi-asserted-by":"crossref","first-page":"108","DOI":"10.31372\/20190403.1059","article-title":"Impact of lactation support program on initiation of breastfeeding in term infants","volume":"4","author":"Ninan","year":"2019","journal-title":"Asian Pac Isl Nurs J"},{"key":"2023110214011377500_B52","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.jpeds.2015.10.066","article-title":"Outcome at two years after dextrose gel treatment for neonatal hypoglycemia; follow up of a randomized trial","volume":"170","author":"Harris","year":"2016","journal-title":"J Pediatr"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2021-050733\/1554274\/peds_2021050733.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2021-050733\/1554274\/peds_2021050733.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T14:03:14Z","timestamp":1698933794000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/149\/6\/e2021050733\/188021\/Dextrose-Gel-for-Neonates-at-Risk-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,18]]},"references-count":52,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,5,18]]},"published-print":{"date-parts":[[2022,6,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2021-050733","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,18]]},"article-number":"e2021050733"}}