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Huang L, Zhang M, Han S, He L, Li B. Co-word analysis of dynamic blood glucose monitoring in neonatal blood glucose management: A review of published literature. Diabetes Metab Syndr 2023; 17:102851. [PMID: 37716238 DOI: 10.1016/j.dsx.2023.102851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Affiliation(s)
- Lizhu Huang
- The School of Nursing of Jinan University, Guangzhou, Guangdong, 510630, China.
| | - Meng Zhang
- The School of Nursing of Jinan University, Guangzhou, Guangdong, 510630, China.
| | - Shasha Han
- Department of Neonatology and Pediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China.
| | - Lilan He
- Department of Neonatology and Pediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China.
| | - Bingxiao Li
- Department of Neonatology and Pediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China.
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Association between neonatal hyperglycemia and retinopathy of prematurity: a meta-analysis. Eur J Pediatr 2021; 180:3433-3442. [PMID: 34114080 DOI: 10.1007/s00431-021-04140-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 02/05/2023]
Abstract
Through a meta-analysis, we aimed to investigate whether neonatal hyperglycemia was associated with an increased risk of retinopathy of prematurity (ROP) by summarizing all available observational evidence. We searched online databases for studies published prior to December 2020; 26745 neonates with 3227 cases of ROP in 11 case-control studies and 997 neonates with 496 cases of hyperglycemia in 5 cohort studies were included. The results showed that the association between hyperglycemia and the occurrence of ROP was statistically significant in case-control studies (OR 3.93, 95% CI 2.36-6.53) and cohort studies (OR 1.70, 95% CI 1.11-2.60). Besides, the borderline significant association between the duration of hyperglycemia and ROP was observed in case-control studies (MD = 1.96, 95% CI 0.90-3.03; adjusted OR = 1.08, 95% CI 1.01-1.15). Furthermore, we found that the mean blood glucose level is higher in the ROP group than the non-ROP group in case-control studies (MD = 14.86, 95% CI 5.06-24.66) and the mean blood glucose level is higher in the hyperglycemia group than in the non-hyperglycemia group (MD = 86.54, 95% CI 11.03-162.05). However, after adjusting other confounders, the association between the mean blood glucose level and ROP varied in cohort studies (OR 1.96, 95% CI 1.23-3.13) and case-control studies (OR 1.02, 95% CI 1.00-1.05).Conclusion: This meta-analysis demonstrates that preterm infants with hyperglycemia have a tendency to increase the risk of ROP. Further studies will be required to achieve a firm conclusion for hyperglycemia and ROP and promote a better understanding of the prevention of ROP.Trial registration: CRD42021228733 What is Known: • Hyperglycemia including the duration and daily mean blood glucose concentration has been associated with the risk of developing ROP in some clinical studies. Current evidence cannot reach a consensus on whether neonatal hyperglycemia is a risk factor for ROP. What is New: • This meta-analysis demonstrates that preterm infants with hyperglycemia have a tendency to increase the risk of ROP. • While the association between the mean blood glucose level and ROP remains inconclusive.
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Almeida AC, Silva GA, Santini G, Brízido M, Correia M, Coelho C, Borrego LM. Correlation between hyperglycemia and glycated albumin with retinopathy of prematurity. Sci Rep 2021; 11:22321. [PMID: 34785747 PMCID: PMC8595310 DOI: 10.1038/s41598-021-01861-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 05/17/2021] [Indexed: 11/09/2022] Open
Abstract
To determine the association between hyperglycemia, glycated albumin (GlyA) and retinopathy of prematurity (ROP). Prospective study of all infants under ROP screening from March 2017 to July 2019. All demographic, clinical and laboratory data were collected. Glucose was measured at birth and every 8 h for the first week and serum GlyA was evaluated at birth, 1st, 2nd and 4th weeks after birth. Reference range for GlyA was obtained. Univariate logistic regression was used to examine risk factors for ROP followed by multivariate regression. A total of 152 infants were included in the study. Median gestational age was 30 weeks and median birth weight 1240 g. Thirty-three infants (21.7%) had ROP. Hyperglycemia was present in 24 (72.7%) infants diagnosed with any ROP versus 6 (0.05%) in those without ROP. Median GlyA at birth, 1st, 2nd and 4th and respective reference ranges were 8.50% (6.00-12.65), 8.20% (5.32-11.67), 8.00% (5.32-10.00) and 7.90% (5.30-9.00) respectively. After multivariate logistic regression, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors (Exp (B) 28.062, 95% CI for Exp(B) 7.881-99.924 p < 0.001). In our cohort, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors.
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Affiliation(s)
- Ana C Almeida
- Department of Ophthalmology, Hospital Beatriz Angelo, Loures, Av. Carlos Teixeira 3, 2674-514, Loures, Portugal. .,Neonatal Intensive Care Unit, Hospital São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental, Estr. Forte do Alto Duque, 1449-005, Lisbon, Portugal. .,CEDOC, Chronic Diseases Research Center, NOVA Medical School - Universidade Nova de Lisboa, Campo dos Mártires da Pátria 130, 1169-056, Lisbon, Portugal. .,Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 1169-056, Lisbon, Portugal. .,Department of Ophthalmology, Luz Saúde, Hospital da Luz, Av. Lusíada 100, 1500-650, Lisbon, Portugal.
| | - Gabriela A Silva
- iNOVA4Health, CEDOC, NOVA Medical School, NMS, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 1169-056, Lisbon, Portugal
| | - Gabriele Santini
- R&D Department, Instrumentation Laboratory - A Werfen Company, Viale Monza, 338, 20128, Milan, Italy
| | - Margarida Brízido
- Department of Ophthalmology, Hospital Beatriz Angelo, Loures, Av. Carlos Teixeira 3, 2674-514, Loures, Portugal
| | - Miguel Correia
- Escola Superior de Saúde Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
| | - Constança Coelho
- Faculdade Medicina de Lisboa, Institute of Environmental Health (ISAMB), University of Lisbon, Av. Prof. Egas Moniz MB, 1649-028, Lisboa, Portugal
| | - Luís Miguel Borrego
- CEDOC, Chronic Diseases Research Center, NOVA Medical School - Universidade Nova de Lisboa, Campo dos Mártires da Pátria 130, 1169-056, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 1169-056, Lisbon, Portugal.,Department of Imunoallergy, Luz Saúde, Hospital da Luz, Av. Lusíada 100, 1500-650, Lisbon, Portugal
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Fernández-Martínez MDM, Gómez-Llorente JL, Momblán-Cabo J, Martin-González M, Calvo-Bonachera M, Olvera-Porcel M, Bonillo-Perales A. Monitoring the incidence, duration and distribution of hyperglycaemia in very-low-birth-weight newborns and identifying associated factors. J Perinat Med 2020; 48:631-637. [PMID: 32432567 DOI: 10.1515/jpm-2020-0074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 03/31/2020] [Indexed: 11/15/2022]
Abstract
Objectives Hyperglycaemia is a common metabolic disorder in very-low-birth-weight (VLBW) infants and is associated with increased morbidity and mortality. The objective is to describe the incidence, duration, episodes and distribution of hyperglycaemia during the first 7 days of life of VLBW infants. Methods This is a prospective cohort study of 60 newborns weighing <1,500 g. Blood glucose levels were monitored with a continuous glucose monitoring system (CGMS) during the first 7 days of life. Hyperglycaemia was defined as glucose ≥180 mg/dL (≥10 mmol/L). Results Incidence of hyperglycaemia recorded with the CGMS was 36.6% (95%CI: 24.6-50.1). In almost 74.6±5.48% of these cases the duration of the episode exceeded 30 min and in 45.25% (95%CI: 2.26-57.82) it exceeded 2 h. The condition occurred most frequently during the first 72 h of life. One-fifth of cases were not detected with scheduled capillary tests and 84.6% of these had hyperglycaemic episode durations of 30 min or more. Agreement between the two techniques was very good (r=0.90, p<0.001) and the CGMS proved to be reliable, accurate and safe. Hyperglycaemia detected by a CGMS is associated with lower gestational age (OR: 0.66, p=0.002), lower birth weight (OR: 0.99, p=0.003), the use of ionotropic drugs (OR: 11.07, p=0.005) and death (OR: 10.59, p=0.03), and is more frequent in preterm infants with sepsis (OR: 2.73, p=0.1). No other association was observed. Conclusions A CGMS could be useful during the first week of life in VLBW infants due to the high incidence and significant duration of hyperglycaemia and the high proportion of cases that remain undetected. The advantage of the CGMS is that it is able to detect hyperglycaemic episodes that the capillary test does not.
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Affiliation(s)
- María Del Mar Fernández-Martínez
- Department of Paediatrics Service, Hospital Universitario Torrecardenas, Hermandad de Donantes de sangre s/n, Almería, 04009, Spain
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Mohsen L, Abou-Alam M, El-Dib M, Labib M, Elsada M, Aly H. A prospective study on hyperglycemia and retinopathy of prematurity. J Perinatol 2014; 34:453-7. [PMID: 24674983 DOI: 10.1038/jp.2014.49] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 02/14/2014] [Accepted: 02/14/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Retinopathy of prematurity (ROP) constitutes a significant morbidity in premature infants that can lead to blindness. Multiple retrospective studies have identified neonatal hyperglycemia as a risk for developing ROP. However, in the absence of any reported prospective study, it is not clear whether hyperglycemia is associated with ROP independent of the commonly associated comorbidities. The objective of this study was to investigate whether hyperglycemia in premature infants is independently associated with ROP. STUDY DESIGN Premature infants (<1500 g or⩽32 weeks gestational age) were enrolled in a prospective longitudinal cohort study. All demographic, clinical and laboratory data were collected. Bedside whole-blood glucose concentration was measured every 8 h daily for 7 days. For any glucose reading<50 or>150 mg dl(-1), serum sample was sent to the laboratory for confirmation. Hyperglycemia was defined as any blood glucose level⩾150 mg dl(-1). ROP patients were compared with non-ROP patients in a bivariate analysis. Variables significantly associated with ROP were studied in a logistic regression model. RESULT A total of 65 patients were enrolled with gestational age 31.1±1.2 weeks and birth weight 1385±226 g. Thirty-one patients (48%) were identified with hyperglycemia. On eye examination, 19 cases (29.2%) had ROP (13 with stage 1, 4 with stage 2 and 2 with stage 3). There were more cases of ROP in the hyperglycemia group compared with the euglycemia group (45% vs 15%, P=0.007). Patients who developed ROP had significantly higher maximum and average glucose concentrations when compared with non-ROP patients. Multiple factors have been associated with ROP on bivariate analysis, including gestational age, exposure to oxygen, respiratory support and poor weight gain. However, in a logistic regression model including all significant variables, average blood glucose in the first week of life was the factor independently associated with ROP with an odds ratio of: 1.77 (95% confidence interval: 1.08 to 2.86), P=0.024. CONCLUSION In a cohort of premature infants, elevated average blood glucose concentrations in the first week of life is independently associated with the development of ROP.
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Affiliation(s)
- L Mohsen
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M Abou-Alam
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M El-Dib
- Department of Neonatology, The George Washington University and Children's National Medical Center, Washington, DC, USA
| | - M Labib
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M Elsada
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - H Aly
- Department of Neonatology, The George Washington University and Children's National Medical Center, Washington, DC, USA
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