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Lower vs traditional treatment threshold for neonatal hypoglycemia

New England Journal of Medicine Feb 14, 2020

van Kempen AAMW, Eskes PF, Nuytemans DHGM, et al. - This study was attempted to ascertain whether a management strategy that used a lower threshold (treatment administered at a glucose concentration of < 36 mg per deciliter [2.0 mmol per liter]) would be noninferior to a traditional threshold (treatment at a glucose concentration of < 47 mg per deciliter [2.6 mmol per liter]) concerning psychomotor development at 18 months, evaluated with the Bayley Scales of Infant and Toddler Development, third edition, Dutch version (Bayley-III-NL; scores range from 50 to 150 [mean { ± SD}, 100 ± 15]), with higher scores showing more advanced development and 7.5 points (one half the SD) representing a clinically important difference). Researchers designed a multicenter, randomized, noninferiority trial involving 689 otherwise healthy newborns born at 35 weeks of gestation or later and identified as being at risk for hypoglycemia to compare two threshold values for treatment of asymptomatic moderate hypoglycemia. The results showed that, at 18 months, a lower glucose treatment threshold (36 mg per deciliter) was noninferior to a traditional threshold (47 mg per deciliter) concerning psychomotor development in otherwise healthy newborns with asymptomatic moderate hypoglycemia.
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