How Much Glucose Is in the Gel Used to Treat Neonatal Hypoglycemia?

Objective: To compare glucose concentrations in three sections of individual tubes and among tubes of commercial oral glucose gels commonly used to treat neonatal hypoglycemia in the United States (Glutose 15 [Perrigo, Minneapolis, MN] and Insta-Glucose [Valeant Pharmaceuticals North America LLC, Bridgewater, NJ]). Design: A quantitative laboratory study. Methods: We measured glucose concentrations in aliquots taken from the top, middle, and bottom sections of three different lots and in whole tubes from different lots of Glutose 15 and Insta-Glucose. We measured the glucose content in the gel using hexokinase and glucose-6-phosphate dehydrogenase enzymes on the Siemens ADVIA 1800 analyzer (Siemens Healthcare Diagnostics, Inc., Tarrytown, NY). Results: The percent difference observed among the three sections of the Glutose 15 tubes was 12.3% to 53.8%. The difference among the three sections of the Insta-Glucose tubes was 40.7% to 79.6%. The concentration of glucose gel is labeled as 40%, but the actual concentration in aliquots of Glutose 15 ranged from 39.64% to 70.96%. The actual concentration in aliquots of Insta-Glucose ranged from 16.45% to 27.47%. The difference in the concentration of glucose among three lots of whole tubes of Glutose 15 was 1.6%, and the difference in concentration among three lots of whole tubes of Insta-Glucose was 8.8%. In Glutose 15, the concentration ranged from 48.3% to 49.1%, and InstaGlucose, the concentration ranged from 17.2% to 18.8%. Conclusion: Glucose was not uniformly distributed within tubes of Glutose 15 and Insta-Glucose, and this may account for variable results on the efficacy of oral glucose gel as a treatment for neonatal hypoglycemia. JOGNN, 51, 218-224; 2022. https://doi.org/10.1016/j.jogn.2021.11.001 Accepted November 16, 2021; Published online December 16, 2021

Automated summary

This study compared the glucose concentrations in different sections and among tubes of two commercially available oral glucose gels commonly used to treat neonatal hypoglycemia. The results showed that the distribution of glucose within these gels was uneven, which may account for the inconsistent efficacy of oral glucose gel as a treatment for neonatal hypoglycemia.