PhD Student University of Padova: Department of Woman and Child's health, Neonatal Intensive Care Unit Padova, Veneto, Italy
Background: Preterm infants are exposed to glycaemic instability whose pathophysiology is multifactorial. Nutritional intake, mainly parenterally, could influence the incidence of both hypoglycemia and hyperglycemia which, in turn, could negatively influence short- and long-term outcome. Objective: To investigate the effect of macronutrients intake on the time spent in hypoglycemia and hyperglycemia detected with continuous glucose monitoring (CGM). Design/Methods: Retrospective analysis of macronutrients intake and CGM data from the BabyGlucolight study (NCT04347590). Participants included preterm infants born at the Neonatal Intensive Care Unit of the University Hospital of Padua ≤32 weeks gestational age (GA) or with a birthweight ≤1500 g (BW). CGM was started within 48 hours of life. Hypoglycemia was defined as sensor glucose value < 4 mmol/L (72mg/dL) while hyperglycemia >8 mmol/L (144mg/dL). Macronutrients intake, given both parenterally and enterally, was collected daily and retrospectively correlated with glucose profile of the first three days of monitoring through multivariate regression analysis. Results: Data from 30 participants were included, median GA=29.9 w (29.1; 31.2), median BW=1230.5 g (1040.0; 1458.6). The preliminary analysis showed a median percentage of time in euglycemia of 88.5% (63.7; 97.3) on day 1 without a significant difference across the three days of monitoring. Glucose, amino acid and lipid intakes increased from a median of 8.0 g/kg (7,1; 9,4), 1.9 g/kg (1.4; 2.1) and 1.3g/kg (1.1;1.5) on day 1 respectively to 12.5 g/kg (11; 13,7), 3 g/kg (2.0; 3.7) and 2.6 g/kg (1.7;3.8) on day 3 respectively, as shown in figure 1. The preliminary analysis demonstrated an inverse relationship between the total intake of amino acids and the time spent in hypoglycemia (p=0.011, r=-0.460) in the absence of significant associations between lipid and glucose and the hypoglycemic time, as shown in Figure2.
Conclusion(s): Our analysis demonstrates that amino acid intake influences glycemic homeostasis in preterm infants during the first week of life, with a higher intake of aminoacids associated to a reduced time spent in the hypoglycemic range.
