This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Hyperglycemia is frequently occurring in very premature infants receiving TPN. Incidence figures of 50-80% have been reported. Most of these studies are, however, 10-15 years old. Hyperglycemia has been associated with the degree of prematurity, infusion rates of glucose, illness e.g. sepsis. It has also been associated with osmotic diuresis, urinary gulcose loss, hyperosmolarity and cerebral bleedings. There is controversy regarding 1) the true relations between the above factors and hyperglycemia; 2) the real risks associated with hyperglycemia; 3) threshold for 'acceptable' hyperglycemia; 4) effects of treatment such as insulin; 5) the incidence of hypoglycemia during insulin treatment. The nutritional treatment of very premature infants has changed over the past 5 years, specifically, parenteral amino acids and lipids are now introduced within the first days of birth and the infusion rates are increased rapidly. Thus, as a part of our attempts to optimize the nutritional treatment of these small infants, it is important to evaluate the impact of nutrition and other factors on the development of hyperglycemia, and also the long term effects of different degrees of hyperglycemia.
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