GLUCOSE GEL AS A TREATMENT FOR NEONATAL HYPOGLYCEMIA

Abstract

This article-based dissertation consists of two complete manuscripts related to oral glucose gel, which is used to treat neonatal hypoglycemia (NH). In the first manuscript, a pre and post-intervention retrospective study was completed to examine the effects of the introduction of glucose gel on the exclusive breastfeeding rate and the admission rate to the neonatal intensive care unit (NICU) on neonates over 35 weeks gestation who were at risk for NH in a mother-baby unit of a Baby-Friendly hospital. There were 198 newborns in the pre-intervention sample and 203 in the post-intervention sample. The exclusive breastfeeding rates in the pre-intervention group were similar to those of the post-intervention group (56.6% of 198 vs. 59.1% of 203, p = .62), as were the NICU admission rates for NH (2.5% of 198 vs. 1.5% of 203, p = .50). In our suburban, Baby-Friendly mother-baby unit, the introduction of glucose gel did not significantly impact the exclusive breastfeeding or NICU admission rates. The second manuscript contains the results of a laboratory study that measured glucose concentrations both within and among tubes in the two brands of oral glucose gel that are used in the United States, Glutose 15™ and Insta-Glucose™. We found that glucose is not uniformly distributed through the tubes with an observed percent difference between the 3 sections of a Glutose 15™ tube of 12.3- 53.8% and between the 3 sections of an Insta-Glucose™ tube of 40.7- 79.6%. The difference in concentration of glucose between whole tubes of 3 lots of Glutose 15™ was 1.6% and between 3 lots of Insta-Glucose™ was 8.8%. This lack of consistency may account for the mixed results in the literature about the effectiveness of oral glucose gel as a treatment for NH. The dissertation concludes with a discussion, limitations, implications for nursing practice, and areas for future research.