Plasma Glucose and Insulin Changes during IV Theophyline Therepy in Preterm Infants with Apnea

Yoon, Young Wook; Oh, Yeon Kyun; Lee, Eun Hee; Song, Jung Youl

Abstract

PURPOSE: The purpose of this study was to evaluate the effects of theophylline in preterm infants with apnea on glucose homeostasis and insulin values. METHOD: In this prospective study, level of glucose and insulin were measured from peripheral blood of 8 neonates(1,450+/-114gm, 31+/-2.1week), who were admitted from April 1, 1997 to July 30, 1997 in Neonatal Intensive Care Unit of Wonkwang University Hospital, for apnea of prematurity(> 20 sec with bradycardia and/or cyanosis) were given aminophylline intravenously. Blood samples were collected at pretreatment, posttreatment 2hours, 1-2days, 3-4days, 5-7days and posttreatment 48hours, and compare to those of the 8 control neonates(1,711+/-232gm, 32+/-1.7week).
RESULTS
The results were as follows: 1) Plasma glucose values were significantly higher in the treatment group than those of the control group at 1-2days(104.67+/-20.39mg/dL vs 83.43+/-15.86mg/dL) and 3-4days(111.0+/-32.39mg/dL vs 79.25+/-14.03mg/dL)(p<0.05). 2) Plasma glucose values which were increased at 1-2days(104.67+/-20.39mg/dL)and 3-4days(111.0+-32.39mg/dL), were significantly higher than pretreatment values(66.33+/-31.19mg/ dL)(p<0.02), but were not increased to the level of hyperglycemia(> 125mg/dL). 3) The mean posttreatment glucose levels drawn at 48hours after discontinuation of theophylline was significantly decreased to the values of pretreatment values compared to those of the 1-2days and 3-4days(p<0.01). 4) Insulin concentrations were also increased insignificantly when blood glucose were increased in the treatment group compared with control group.
CONCLUSION
In conclusion, intravenous administration of theophylline produces hyperglycemia significantly, including an increase in a serum insulin. But, clinically significant hyperglycemia(> 125mg/dL) was not noted. So, plasma glucose may not need to be monitored in preterm apneic infants receiving theophylline. But, further studies are need to elucidate the effect of theophylline considering the serum toxic level of theophylline.