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Effectiveness of oral dextrose gel for neonates at risk of hypoglycemia: A systematic review, meta-analysis, and GRADE assessment of randomized controlled trials

Journal of Perinatology volume 45, pages 1335–1344 (2025)Cite this article

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Abstract

Neonatal hypoglycemia is the most common metabolic disorder in newborns and can lead to neurological damage if untreated. While intravenous dextrose is the standard treatment, it is invasive. Oral 40% dextrose gel (0.5 ml/kg) offers a non-invasive alternative. A systematic review of five randomized controlled trials (RCTs), involving 2,742 neonates (1,326 received dextrose gel; 1,416 received placebo), assessed its effectiveness in reducing NICU admissions in neonates with blood glucose < 2.6 mmol/L. Although the overall meta-analysis showed a non-significant reduction in NICU admissions (risk ratio 0.68; 95% CI: 0.33–1.38; p = 0.28), a sensitivity analysis excluding one outlier study improved consistency (I² = 19%) and revealed a statistically significant reduction (risk ratio 0.52; 95% CI: 0.31–0.90; p = 0.02). These findings suggest that oral dextrose gel may reduce NICU admissions in neonates with hypoglycemia, but further large-scale studies are required to confirm its clinical effectiveness.

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Funding

The authors did not receive any specific grants from public, commercial, or not-for-profit funding agencies for this research.

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Authors and Affiliations

  1. Department of Maxillofacial Prosthodontics, Ragas Dental College and Hospital, Uthandi, Chennai, Tamil Nadu, 600119, India

    Gowardhan Sivakumar

  2. Clinical Research Laboratory, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, 400012, India

    Periyasamy Kuppusamy

  3. Department of Orthodontics, Sri Venkateshwaraa Dental College, Villupuram Main Rd, Ariyur, Pondicherry, 605102, India

    Lakshmi Prasanna P

  4. Department of Physiology, JIET Medical College and Hospital, Jodhpur, Rajasthan, 342802, India

    Abha Mishra

  5. Discovery Research Division, Indian Council of Medical Research, ICMR Headquarters, Ansari Nagar, New Delhi, 110029, India

    Sasidharan Sivakumar

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  3. Lakshmi Prasanna P
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Contributions

GS and SS: Conceptualization of the study, supervision, initial screening of studies, quality assessment of included studies, statistical analysis, manuscript drafting, and critical review of the manuscript, P K: Validation of results, supervision of screening of studies, quality assessment of included studies, and drafting of the discussion section, critical review and final approval of the manuscript, L P: Data collection, literature review, initial screening of studies, quality assessment of included studies, and drafting of the methodology section, A M: Supervision of data extraction, and critical revision of the manuscript.

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Correspondence to Sasidharan Sivakumar.

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Sivakumar, G., Kuppusamy, P., P, L.P. et al. Effectiveness of oral dextrose gel for neonates at risk of hypoglycemia: A systematic review, meta-analysis, and GRADE assessment of randomized controlled trials. J Perinatol 45, 1335–1344 (2025). https://doi.org/10.1038/s41372-025-02387-x

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