Glucose disturbances in very low‐birthweight infants—Results from the prospective LIGHT study

Aim To describe glucose homeostasis disturbances (dysglycaemia) in very low‐birthweight infants (<1500 g) during the admission period and explore associated risk factors. Methods The LIGHT (very low‐birthweight infants ‐ glucose and hormonal profile over time) study was a prospective observational cohort study that included 49 very low‐birthweight infants admitted to the tertiary neonatal intensive care unit in Umeå, Sweden, during 2016–2019. All glucose concentrations ( n = 3515) sampled during the admission period were registered. Results Hyperglycaemia >10 mmol/L and hypoglycaemia <2.6 mmol/L were registered in 63% and 55% of the infants, respectively. Onset of dysglycaemia occurred almost exclusively in the first postnatal week. Hyperglycaemia followed 15% of corticosteroid doses given; all were preceded by pre‐existing hyperglycaemia. Pre‐existing hyperglycaemia was found in 66.7% of hyperglycaemic infants who received inotrope treatment. Upon commencement, 72.5% of antimicrobial treatments given were neither preceded nor followed by hyperglycaemia. Conclusion Dysglycaemia was common in very low‐birthweight infants. Daily means of glucose concentrations seemed to follow a postmenstrual age‐dependent pattern, decreasing towards term age suggesting a postmenstrual age‐dependent developmental mechanism. The primary mechanism causing hyperglycaemia was independent of sepsis, and corticosteroid and inotrope treatments. No hypoglycaemia was registered during ongoing insulin treatment.