High blood sugar levels and insulin treatment in preterm babies. The HINT trial.

Many very preterm and small babies develop high blood sugar levels in the first few days to weeks after birth. Recent studies in critically ill adults with high blood sugar levels have shown that treatment with insulin to keep blood sugar levels in the normal range improved survival and reduced complications, regardless of whether the patients were diabetic or not. However, we do not know if the same is true for preterm babies. The purpose of this study is therefore to find out if babies with high blood sugar levels do better if their blood sugar level is kept in the normal range (4-6 mmol/l) with insulin treatment compared with the current practice of aiming for a blood sugar level less than 10 mmol/l. This study is a pilot study to determine if treatment is feasible in the newborn and improves growth. If successful, this would lead to a multi centre trial to determine if this treatment decreases mortality or improves neurodevelopmental outcome at 2 years of age.