• Matthew J Glasgow, Jane E Harding, Richard Edlin, and Children with Hypoglycemia and Their Later Development (CHYLD) Study Team.
• Liggins Institute, University of Auckland, Auckland, New Zealand.
• J. Pediatr. 2018 Jul 1; 198: 151-155.e1.

ObjectiveTo evaluate the costs of using dextrose gel as a primary treatment for neonatal hypoglycemia in the first 48 hours after birth compared with standard care.Study DesignWe used a decision tree to model overall costs, including those specific to hypoglycemia monitoring and treatment and those related to the infant's length of stay in the postnatal ward or neonatal intensive care unit, comparing the use of dextrose gel for treatment of neonatal hypoglycemia with placebo, using data from the Sugar Babies randomized trial. Sensitivity analyses assessed the impact of dextrose gel cost, neonatal intensive care cost, cesarean delivery rate, and costs of glucose monitoring.ResultsIn the primary analysis, treating neonatal hypoglycemia using dextrose gel had an overall cost of NZ$6863.81 and standard care (placebo) cost NZ$8178.25; a saving of NZ$1314.44 per infant treated. Sensitivity analyses showed that dextrose gel remained cost saving with wide variations in dextrose gel costs, neonatal intensive care unit costs, cesarean delivery rates, and costs of monitoring.ConclusionsUse of buccal dextrose gel reduces hospital costs for management of neonatal hypoglycemia. Because it is also noninvasive, well tolerated, safe, and associated with improved breastfeeding, buccal dextrose gel should be routinely used for initial treatment of neonatal hypoglycemia.Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12608000623392.Copyright © 2018 Elsevier Inc. All rights reserved.

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