Is Insulin the Safest Approach to Treat Hyperglycemia in Preterm Infants under 37 weeks GA? Evidence-based Approach to a Clinical Question for the Postgraduate Child Health Diploma's EBM Module

Dr. Mai Mustafa Salih Ali

Abstract: This comprehensive review explores the management of hyperglycemia in preterm neonates, focusing on the use of insulin therapy and its impact on long-term outcomes. Two relevant observational studies and a randomized controlled trial are analyzed to assess the safety and effectiveness of insulin treatment in hyperglycemic preterm infants. The review also delves into the critical appraisal of these studies, discussing their methodology, statistical significance, and limitations. Key outcomes include the frequency of hypoglycemic episodes and the neurodevelopmental impact of hyperglycemia in these neonates. While the studies show that insulin infusion for hyperglycemia appears safe with no significant effects on morbidity and mortality, questions remain regarding its impact on long-term neurodevelopment. This review sheds light on the complex issue of hyperglycemia management in preterm neonates, providing valuable insights for healthcare professionals and researchers in neonatology.

Keywords: Preterm neonates, hyperglycemia, insulin therapy, long-term outcomes, hypoglycemic episodes