Robert Godin1, Martha Taboada2, Doron J Kahn3,4. 1. Department of Pharmacy, Joe DiMaggio Children's Hospital, Hollywood, FL, USA. 2. Division of Pediatric Endocrinology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA. 3. Division of Neonatology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA. dkahn@mhs.net. 4. Envision Healthcare, Plantation, FL, USA. dkahn@mhs.net.
Abstract
INTRODUCTION: Consensus regarding optimal glucagon dosing for management or diagnosis of neonatal/infant hypoglycemia has not been established. OBJECTIVE: To investigate glycemic effects of glucagon dosed ≤0.2 mg/kg (Gnlow) vs. >0.2 mg/kg (Gnhigh) in neonatal/infant hypoglycemia. STUDY DESIGN: Retrospective, observational, cohort study. RESULTS: Glucagon administration at any dose resulted in 75/77 (97.4%) samples meeting criteria for normoglycemia (plasma glucose >60 mg/dL), and plasma glucose increases of >30 mg/dL occurred in 74.2% vs. 63% (NS) of samples in the Gnlow and Gnhigh groups, respectively. Despite equivalent glucagon dosing, there was a trend toward smaller (<2500 g) patients achieving post-glucagon plasma glucose increases of >30 mg/dL less often than their bigger (≥2500 g) counterparts (60% vs. 74.1%, NS). CONCLUSIONS: Glucagon is highly effective in raising plasma glucose levels in neonatal/infant hypoglycemia. No differences in glycemic effects were noted between either dosing regimen. However, glycemic effects may be diminished in lower weight patients.
INTRODUCTION: Consensus regarding optimal glucagon dosing for management or diagnosis of neonatal/infant hypoglycemia has not been established. OBJECTIVE: To investigate glycemic effects of glucagon dosed ≤0.2 mg/kg (Gnlow) vs. >0.2 mg/kg (Gnhigh) in neonatal/infant hypoglycemia. STUDY DESIGN: Retrospective, observational, cohort study. RESULTS:Glucagon administration at any dose resulted in 75/77 (97.4%) samples meeting criteria for normoglycemia (plasma glucose >60 mg/dL), and plasma glucose increases of >30 mg/dL occurred in 74.2% vs. 63% (NS) of samples in the Gnlow and Gnhigh groups, respectively. Despite equivalent glucagon dosing, there was a trend toward smaller (<2500 g) patients achieving post-glucagon plasma glucose increases of >30 mg/dL less often than their bigger (≥2500 g) counterparts (60% vs. 74.1%, NS). CONCLUSIONS:Glucagon is highly effective in raising plasma glucose levels in neonatal/infant hypoglycemia. No differences in glycemic effects were noted between either dosing regimen. However, glycemic effects may be diminished in lower weight patients.