Abstract:
Objective: To investigate the success rate of intramuscular (IM) glucagon in preventing need for IV glucose and describe its glycemic effect.
Methods: Retrospective study of 158 consecutive term neonates with feeding-resistant hypoglycemia treated with glucagon.
Results: After glucagon, blood glucose (BG) increased in all but 1 infant by 25.9 ± 17.1, 42.1 ± 21.1, and 39.2 ± 28.3 mg/dL (1.4 ± 0.9, 2.3 ± 1.2, 2.2 ± 1.6 mmol/L) at 30, 60 and 120 mins respectively. In multivariable logistic regression, glucagon success was dependent upon gender (increased male risk) (P = 0.021), meeting American Academy of Pediatrics (AAP) criteria for immediate IV glucose (P = 0.004), birth weight, (P = 0.018) and delta glucose concentration at 60 min (P = 0.013). After IM glucagon, 24 out of 49 infants that met AAP criteria for immediate IV glucose (49%) ended up not requiring any additional intervention.
Conclusions: Glucagon increases BG nearly universally in hypoglycemic infants and allowed reducing the number of infants that needed immediate IV glucose infusion therapy by ≈half.
Reference:
Kasirer Y, Dotan O, Mimouni FB, Wasserteil N, Hammerman C, Bin-Nun A. The use of intramuscular glucagon to prevent IV glucose infusion in early neonatal hypoglycemia. J Perinatol. 2021 Feb 9. doi: 10.1038/s41372-021-00925-x. Epub ahead of print. PMID: 33564107.