University of Auckland: Sugar gel cuts babies’ odds of getting hypoglycaemia

Rubbing sugar gel inside the mouths of newborn babies at risk of hypoglycaemia reduced their odds of developing the disorder.


A nurse demonstrates the method for giving sugar gel to a newborn
That was the finding of a four-year trial conducted in maternity hospitals across New Zealand and Australia.

The research is important because hypoglycaemia (low blood sugar) in newborns can damage the development of a child’s brain and has been associated with diminished educational attainment.

The study by the University of Auckland’s Liggins Institute focused on babies who were at risk of hypoglycaemia from being born preterm, of high or low birthweight, or to mothers with diabetes.

The randomised controlled trial – the ‘gold standard’ of scientific investigation – took place across 18 maternity hospitals in New Zealand and Australia, with 2,149 babies receiving either a dextrose (sugar) gel or a placebo. For every 21 babies treated with the gel, one avoided hypoglycaemia. Funded by the Health Research Council, the study was led by Distinguished Professor Jane Harding and published this week in the international journal PLOS Medicine.


Dame Jane Harding
Sugar gel is already used to treat babies who have developed low blood sugar levels, as a result of the breakthrough 2013 ‘Sugar Babies’ study by Professor Harding and her team. The latest research explored the potential for going one step further, using the gel to prevent babies developing the problem in the first place.

“It may be time for doctors and the medical community to consider whether to adopt dextrose gel as a preventative treatment,” says Professor Harding. “We’ve shown in other studies that it’s likely to be cost-effective and may improve the baby’s later development.”

The latest trial – called hPOD, for hypoglycaemia Prevention with Oral Dextrose – ran from 2015 to 2019. A key aspect now is following up the children at ages two and six, to check on their growth and development to find out if preventing the hypoglycaemia results in better later development.

“We’re very grateful to all the families who have taken part,” says Professor Harding. “Their participation becomes even more valuable through taking part in the two and six-year follow-ups.”

While the study lowered the likelihood of hypoglycaemia for children in the at-risk categories, it didn’t reduce admissions to neonatal intensive care units.


It may be time for doctors and the medical community to consider whether to adopt dextrose gel as a preventative treatment
Jane Harding
“We think this may be because babies who are at risk of low sugar levels are also at risk of having other problems that need extra care,” Professor Harding said in a letter to families, explaining the results of the study.

Hypoglycaemia affects up to 15 percent of newborn babies and 50 percent of those with risk factors. Even transient and treated hypoglycaemia has been associated with impaired visual-motor coordination and executive function at 4.5 years, and with poorer performance on standard school testing of literacy and mathematics at 10 years.

This highlights why prevention may be so important, Professor Harding believes.