Lower versus Traditional Treatment Threshold for Neonatal Hypoglycemia

This multicenter, randomized, noninferiority trial compared two glucose threshold values for treating asymptomatic moderate hypoglycemia in 689 at risk newborns (born at ≥35 weeks’ gestation). The lower threshold (<36 mg/dL) was tested against the traditional threshold (<47 mg/dL) to assess psychomotor development at 18 months using the Bayley III NL scale. Results showed no significant difference in cognitive (102.9 vs. 102.2) or motor scores (104.6 vs. 104.9) between groups, confirming noninferiority (difference <7.5 points). The lower threshold group had fewer interventions (9% fewer glucose measurements, reduced need for intravenous glucose/tube feeding) but more hypoglycemic episodes (57% vs. 47%). Serious adverse events were rare (one death unrelated to treatment). The study supports a lower threshold as safe and reduces overtreatment.

This multicenter, randomized, noninferiority trial compared two glucose threshold values for treating asymptomatic moderate hypoglycemia in 689 at risk newborns (born at ≥35 weeks’ gestation). The lower threshold (<36 mg/dL) was tested against the traditional threshold (<47 mg/dL) to assess psychomotor development at 18 months using the Bayley III NL scale. Results showed no significant difference in cognitive (102.9 vs. 102.2) or motor scores (104.6 vs. 104.9) between groups, confirming noninferiority (difference <7.5 points). The lower threshold group had fewer interventions (9% fewer glucose measurements, reduced need for intravenous glucose/tube feeding) but more hypoglycemic episodes (57% vs. 47%). Serious adverse events were rare (one death unrelated to treatment). The study supports a lower threshold as safe and reduces overtreatment.