Controversies in the management of hyperglycemia in the ELBW infant.

Hyperglycemia is a common problem in newborns undergoing intensive care, especially extremely low birth weight (ELBW) infants. There is a lack of consensus with regard to various aspects of management of neonatal hyperglycemia including definition, optimal management strategy as well as short and long term implications. We reviewed the current evidence in this regard. Recent studies suggest that adequate control of hyperglycemia may be beneficial but long-term implications of hyperglycemia and insulin therapy in the ELBW infants are not known. Awaiting further research, it may be pragmatic to use a more operational definition of hyperglycemia and limit insulin therapy to neonates with high risk of osmolar derangement as per the proposed guideline.