Sector Watch

Study supports lower vitamin K doses in preterm infants

A dose of 0.2 mg (or a dose of 0.3 mg/kg birth weight) vitamin K administered intramuscularly—lower than the one mg typically recommended—is adequate for maintaining vitamin K sufficiency in preterm infants during at least the first postnatal month or until they have been established on milk feeds, a study conducted in the UK shows.

"Preterm infants in many parts of the world are frequently given much higher prophylactic doses than this," study investigator Dr Paul Clarke told Reuters Health. "Our study indicates that lower initial doses of vitamin K are more appropriate for prophylaxis in preterm infants," he added.

Dr Clarke, from Norfolk and Norwich University Hospital, and colleagues assessed vitamin K status and metabolism in 80 preterm infants (< 32 weeks' gestation) randomised to one of three regimens of vitamin K prophylaxis: 0.5 mg IM (control); 0.2 mg IM; or 0.2 mg IV.

Vitamin K prophylaxis with 0.2 mg by IM injection maintained adequate vitamin K status until a median of age 25 postnatal days and did not cause early vitamin K accumulation. Dr Clarke noted that this is the first study to show that a larger vitamin K dose (0.5 mg) or an intravenous dose appears to overload the liver of some premature infants, because it can lead to a build up of serum vitamin K and its metabolites.

"The study findings support the current American Academy of Pediatrics recommendation of a dose of 0.3 mg/kg of vitamin K for preterm infants of birth weight less than 1,000 grams," according to Dr Clarke. The findings also suggest that breast fed preterm infants who receive lower dose prophylaxis at birth "may be at risk of later vitamin K deficiency bleeding unless they are provided with further supplementary vitamin K in their milk feeds," he said. This study, Dr Clarke and colleagues conclude, "should guide more appropriate vitamin K-dosing regimens for preterm infants and support the tailoring of initial prophylactic doses to their lower body mass and underdeveloped metabolic capacity."

Reuters

Internet helps diabetics monitor blood sugar

An Internet-based blood sugar monitoring system is superior to making regular visits to a doctor's office for controlling blood sugar and achieving optimal, stable blood sugar levels, according to a long-term study of a group of diabetes patients who used the system.

"Urgently, we need to find a new system for effective glucose control and we suggest that the Internet-based system could be a key for solution of diabetes-related problems," Dr Jae-Hyoung Cho from The Catholic University of Korea, Seoul, told Reuters Health.

With the system, diabetes patients log on to a website and upload their self-obtained blood sugar results on an individualised online chart. They may also post questions, concerns, or issues that might influence blood sugar control in a memo box for their healthcare provider.

Staff members, which in this study included three doctors, a nurse and a dietitian, monitor the system daily and send appropriate responses, as needed, based on the patients' uploaded information.

In their study, reported recently in Diabetes Care, Dr Cho and colleagues randomly assigned 80 type 2 diabetic patients with varying degrees of blood sugar control to conventional management—keeping a written record of blood sugar levels and attending office visits every three months—or to the Internet-based monitoring system for 30 months.

"This feedback and communication could play an important role for improving self-motivation and self-glucose control," Dr Cho said. The researchers found that the peptide injections lowered resistance to insulin, which is used to move blood glucose to the body's cells.

Reuters