Efficiency of Continuous Subcutaneous Insulin Infusion for Premature Neonate: A Case Report

Neonatal hyperglycaemia is common in extremely low birth weight (ELBW, <1,000 g) infants, associated with a number of adverse clinical outcomes, and usually treated with continuous intravenous insulin infusion (CIVII). We report a case of continuous subcutaneous insulin infusion (CSII) in an ELBW neonate (730 g, 25 weeks GA) requiring insulin infusion for transient idiopathic hyperglycaemia. After presenting hyperglycaemia on day 4, the patient was treated with CIVII. From day 12 to 34, CSII was used to replace central venous catheter. Insulin requirements were lower and glycaemia more stable under CSII. No side effect was noticed. CSII was also beneficial for developmental care, allowing parents to be more easily involved in their baby’s care. Thus, CSII appeared to be a safe and reliable alternative for insulin administration in ELBW infants. However, indication and management requires training of the NICU team by paediatric diabetes specialists.