Effectiveness of Oral Glucose Gel in Neonatal Hypoglycemia: A Randomized Controlled Trial

Abstract

Background: Preterm infants are at higher risk of hypoglycemia. Feeding, oral glucose gel and IV dextrose are methods of correction of hypoglycemia. This study focuses mainly on the effectiveness of oral glucose gel in neonatal hypoglycemia when compared to IV dextrose. Methods: This was a prospective interventional randomized controlled study. Neonates born after completion of 32 weeks of gestation with blood glucose levels less than 45 mg/dl were randomized into two groups: one receiving 40% oral glucose gel and the other receiving intravenous 10% dextrose. Blood glucose levels were monitored at defined intervals to assess treatment efficacy and rebound hypoglycemia. Results: Out of 250 neonates included in the study. 126 received oral glucose gel, and 124  received intravenous dextrose. Among neonates treated with oral glucose gel, 105 (84%) achieved euglycemia at 30 minutes, whereas 123 (99%) neonates in the IV dextrose group achieved euglycemia. IV dextrose was significantly more effective than oral glucose gel in correcting hypoglycemia (p < 0.05). Rebound hypoglycemia occurred in 6 neonates in the oral glucose gel group and 7 neonates in the IV dextrose group. Conclusions: Oral 40% glucose gel is effective in correcting neonatal hypoglycemia. However, IV 10% dextrose is more effective than oral glucose gel in correcting hypoglycemia. Oral glucose gel may be a practical and less invasive option for the initial management of asymptomatic or clinically stable neonates, potentially reducing the need for intravenous therapy and NICU admission.