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Glucose Gel as a Treatment Strategy for Transient Neonatal Hypoglycemia

Newnam, Katherine M. PhD, RN, CPNP, NNP-BC; Bunch, Marissa MSN, RN, CPNP

Section Editor(s): Gephart, Sheila

doi: 10.1097/ANC.0000000000000426
Evidence-Based Practice Briefs

Background: Transient asymptomatic neonatal hypoglycemia (TANH) is common as infants transition from their mother's energy stores to their own. There is little evidence supporting the blood glucose threshold that indicates a need for treatment although sustained hypoglycemia has been correlated with negative neurodevelopmental consequences. Treatment of TANH includes a stepwise approach from supplemental enteral feedings, buccal glucose gel, intravenous dextrose infusion, and/or transfer to special care units including neonatal intensive care units.

Purpose: The purpose of this evidence-based practice brief is to review current evidence on 40% buccal glucose gel administration as a treatment strategy for TANH.

Methods/Search Strategy: CINAHL, Cochrane, Google Scholar, and PubMed were searched using the key words and restricted to English language over the last 7 years.

Findings/Results: The use of buccal dextrose gel for TANH may reduce neonatal intensive care unit admissions, reduce hospital length of stay and cost, support the mother–infant dyad through reduced separation, support exclusive breastfeeding, and improve parental satisfaction without adverse neurodevelopmental consequences.

Implications for Practice: Timely collection of blood glucose levels following intervention is critical to support clinical decisions. Clinicians should offer family education regarding the rationale for serial glucose monitoring and treatment indications including buccal glucose administration. Clinical protocols can be revised to include use of buccal dextrose gel.

Implications for Research: There is a need for rigorous long-term studies comparing treatment thresholds and neurodevelopmental outcomes among various treatment strategies for TANH.

University of Tennessee Knoxville, College of Nursing, Knoxville (Dr Newnam); Children's Hospital of the King's Daughters, Norfolk, Virginia (Dr Newnam); and The University of Tennessee Chattanooga, School of Nursing, Chattanooga (Ms Bunch).

Correspondence: Katherine M. Newnam, PhD, RN, CPNP, NNP-BC, University of Tennessee, Knoxville, 1200 Volunteer Blvd, Knoxville, TN 37996 (

This study was performed at The University of Tennessee Knoxville.

Dr. Newnam, who is a Section Editor for Advances in Neonatal Care and the coauthor and mentor to the primary author, was not involved in the editorial review or decision to publish this article. The entire process from submission, referee assignment, and editorial decisions was handled by other members of the editorial team for the journal.

The authors have no conflicts of interest to declare.

© 2017 by The National Association of Neonatal Nurses