Continuous infusion of insulin in hyperglycemic low-birth weight infants receiving parenteral nutrition with and without lipid emulsion.

The efficiency of a continuous infusion of insulin in improving glucose tolerance was compared in two groups of very low-birth weight infants (mean +/- SEM birth weights 757 +/- 40 vs 828 +/- 80 g and gestational ages 27.6 +/- 0.7 vs. 27.2 +/- 0.5 weeks) receiving total parenteral nutrition with and without the addition of lipid emulsion to the nutrition regimen. The mean +/- SEM cumulative doses of insulin (0.87 +/- 0.1 vs 1.15 +/- 0.3 U/kg) and hours required to decrease the blood glucose level to 120 mg/dL (9.1 +/- 0.8 vs 9.5 +/- 1.0 hours) were similar. Insulin was delivered with a syringe pump used for other routine purposes in the neonatal intensive care unit. Continuous intravenous insulin infusion is an effective, inexpensive, safe method for maintaining glucose homeostasis in low-birth weight infants who develop hyperglycemia as a consequence of total parenteral nutrition.