{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:46:01Z","timestamp":1787071561446,"version":"build-2736575974"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>This case series documents two very low birth weight neonates who presented with spontaneous hyperglycemia even after discontinuation of steroids in a critical care setting. Despite attempts to regulate their glucose levels using intravenous insulin infusion as per standard protocol, we faced challenges with dosage adjustment and observed significant fluctuations in their blood sugar levels requiring frequent glycemic monitoring (every 2 hours). As hyperglycemia continued, we decided to switch to the subcutaneous route of administration and reduce the frequency of glycemic monitoring. However, due to weight-based insulin dose calculation, a very low insulin dose had to be administered necessitating insulin dilution. Due to unavailability of commercial diluents, we explored saline as a diluent for glargine based on acidic pH similarity between glargine and saline. We observed that the saline-diluted glargine administered subcutaneously was effective in managing hyperglycemia, and their blood glucose levels stabilized within the desired range requiring less frequent monitoring (every 6 hours).<\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_2029_24","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T15:02:53Z","timestamp":1758639773000},"page":"3542-3545","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effective use of saline-diluted subcutaneous glargine in very low birth weight babies with neonatal hyperglycemia"],"prefix":"10.4103","volume":"14","author":[{"given":"Akhila","family":"Bhandarkar","sequence":"first","affiliation":[{"name":"Nitte (Deemed to be University), KS Hegde Medical Academy (KSHEMA), Mangalore, Department of Endocrinology and Metabolism, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobba Kiran","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Advanced Endocrine and Diabetes Hospital, Kukatpally, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. P.","family":"Praveen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayasree","family":"Chandramathi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"R2-20250924","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.1542\/neo.21-2-e89","article-title":"Hyperglycemia in extremely preterm infants","volume":"21","author":"Ramel","year":"2020","journal-title":"Neoreviews"},{"key":"R3-20250924","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3892\/wasj.2024.252","article-title":"Neonatal hyperglycaemia in extremely preterm and extremely low birth weight infants:A report of a rare case and a review of the literature","volume":"6","author":"Saputri","year":"2024","journal-title":"World Acad Sci J"},{"key":"R4-20250924","first-page":"72","article-title":"Incidence, risk factors and complications of hyperglycemia in very low birth weight infants. Gaz","volume":"65","author":"Akmal","year":"2017","journal-title":"Egypt. Paediatr. Assoc"},{"key":"R5-20250924","doi-asserted-by":"crossref","first-page":"641306","DOI":"10.3389\/fped.2021.641306","article-title":"Hyperglycaemia in the newborn infant. Physiology verses pathology","volume":"9","author":"Beardsall","year":"2021","journal-title":"Front Pediatr"},{"issue":"(Suppl 1)","key":"R6-20250924","first-page":"S234","article-title":"Neonatal hyperglycemia, which threshold value, diagnostic approach and treatment?:Turkish Neonatal and Pediatric Endocrinology and diabetes societies consensus report","volume":"53","author":"\u015eim\u015fek","year":"2018","journal-title":"Turk Arch Pediatr Pediatri Ar\u015f"},{"key":"R7-20250924","first-page":"291","article-title":"Treatment of transient neonatal diabetes mellitus with subcutaneous insulin glargine in an extremely low birth weight neonate","volume":"16","author":"Barone","year":"2011","journal-title":"J Pediatr Pharmacol Ther JPPT Off J PPAG"},{"key":"R8-20250924","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1089\/dia.2014.0055","article-title":"Treatment of transient neonatal diabetes mellitus:Insulin pump or insulin glargine?Our experience","volume":"16","author":"Passanisi","year":"2014","journal-title":"Diabetes Technol Ther"},{"key":"R9-20250924","first-page":"1095","article-title":"Neonatal diabetes mellitus:Patient reports and review of current knowledge and clinical practice","volume":"18","author":"Jeha","year":"2005","journal-title":"J Pediatr Endocrinol Metab JPEM"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_2029_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:48:18Z","timestamp":1787068098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_2029_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":8,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_2029_24","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2024-12-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}