# Dextrose gel for newborn low blood sugar Intervention · id `maternal:oral-dextrose-gel` · Maternal & Newborn Atlas · release `fc5a600ec7387e71` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Also called: Oral dextrose gel; 40% dextrose gel Browse, life stage: Newborn Browse, care area: Newborn care ## In plain language A sugar gel (40% dextrose) given to babies with low blood sugar. In the Sugar Babies trial in New Zealand, treatment failed less often with the gel than with a placebo gel. A follow-up at 9 to 10 years found no difference in school achievement but lower scores on one test of visual perception in the gel group. ## Technical summary Sugar Babies (Lancet 2013): treatment failure 14% against 24%, relative risk 0.57 (95% CI 0.33 to 0.98). Mid-childhood follow-up (Neonatology 2023): low educational achievement 42% against 45%; visual perception standard scores 95.2 against 100.6 and low visual perception scores 23% against 11% (relative risk 2.23, 95% CI 1.13 to 4.37). The authors concluded that dextrose gel does not appear to cause clinically significant differences in educational achievement or other neurodevelopmental outcomes. Both are single-population results for the contexts stated in the claims. ## Claims, with the population each applies to ## Context: At-risk babies of 35 to 42 weeks with low blood sugar (Sugar Babies trial) Recipient: Newborn; Population: Babies of 35 to 42 weeks of gestation, younger than 48 hours old and at risk of hypoglycaemia. Of 514 enrolled babies, 242 (47%) became hypoglycaemic and were randomised; 237 were analysed.; Care setting: A tertiary centre in New Zealand.; Geography: New Zealand; Life stage: Newborns of 35 to 42 weeks of gestation, under 48 hours old. No gestational or postnatal bound is set in the structured fields because the abstract gives the ages as a range and in hours.; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Treatment failure was a blood glucose concentration under 2.6 mmol/L after two treatment attempts. ### In the Sugar Babies trial in New Zealand, babies with low blood sugar who were given 40% dextrose gel (200 mg/kg) had treatment failure less often than babies given placebo gel: 14% (16 babies) against 24% (29 babies), relative risk 0.57 (95% CI 0.33 to 0.98; p=0.04). Treatment failure meant a blood glucose concentration under 2.6 mmol/L after two treatment attempts. The authors noted no serious adverse events. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Newborn; Population: Babies of 35 to 42 weeks of gestation, younger than 48 hours old and at risk of hypoglycaemia. Of 514 enrolled babies, 242 (47%) became hypoglycaemic and were randomised; 237 were analysed.; Care setting: A tertiary centre in New Zealand.; Geography: New Zealand; Life stage: Newborns of 35 to 42 weeks of gestation, under 48 hours old. No gestational or postnatal bound is set in the structured fields because the abstract gives the ages as a range and in hours.; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Treatment failure was a blood glucose concentration under 2.6 mmol/L after two treatment attempts. - Limitations: Single tertiary centre in New Zealand. Babies were of 35 to 42 weeks of gestation and under 48 hours old, and the comparison was with feeding alone plus placebo gel. Treatment failure is a short-term blood glucose outcome; later outcomes are in the mid-childhood follow-up claim. Only the abstract was read. - Last checked: Not recorded - Sources: 1. Supports: Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentences 3 and 4. Retrieved 2026-10-14T18:24:00Z. Source state: Current. Snapshot hash: d3194e08b3e533501948fc09092b8bd698ba412808141e6be91f24d3365131ed. How it applies: Treatment failure result and adverse events. 2. Background: Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentences 1, 2 and 5. Retrieved 2026-10-14T18:24:00Z. Source state: Current. Snapshot hash: d3194e08b3e533501948fc09092b8bd698ba412808141e6be91f24d3365131ed. How it applies: Setting, population, doses and the definition of treatment failure. 3. Background: Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentences 1 and 2. Retrieved 2026-10-14T18:24:00Z. Source state: Current. Snapshot hash: d3194e08b3e533501948fc09092b8bd698ba412808141e6be91f24d3365131ed. How it applies: Numbers enrolled, randomised and analysed. ## Context: Children aged 9 to 10 years who were treated as newborns in the Sugar Babies trial (mid-childhood follow-up) Recipient: Newborn; Population: The recipient of the treatment was the newborn; the measured population is the same people as children at a mean age of 9.3 years: 184 of 227 eligible children (81%), who had been randomised as babies to dextrose gel or placebo gel.; Care setting: Not stated in the abstract.; Geography: Not stated in this abstract. The original trial ran in New Zealand.; Life stage: Mid-childhood, 9 to 10 years of age, after treatment as newborns; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: One follow-up assessment at a mean age of 9.3 years. The primary outcome was low educational achievement in reading or mathematics. ### At 9 to 10 years of age, children who had received dextrose gel as newborns did not differ from the placebo group in low educational achievement (42% against 45%; relative risk 1.04, 95% CI 0.76 to 1.44), but had lower visual perception standard scores (95.2 against 100.6; mean difference -5.68, 95% CI -9.79 to -1.57) and more low visual perception scores (23% against 11%; relative risk 2.23, 95% CI 1.13 to 4.37). Other secondary outcomes were similar. The authors concluded that dextrose gel does not appear to cause clinically significant differences in educational achievement or other neurodevelopmental outcomes. - Category: Safety - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Newborn; Population: The recipient of the treatment was the newborn; the measured population is the same people as children at a mean age of 9.3 years: 184 of 227 eligible children (81%), who had been randomised as babies to dextrose gel or placebo gel.; Care setting: Not stated in the abstract.; Geography: Not stated in this abstract. The original trial ran in New Zealand.; Life stage: Mid-childhood, 9 to 10 years of age, after treatment as newborns; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: One follow-up assessment at a mean age of 9.3 years. The primary outcome was low educational achievement in reading or mathematics. - Limitations: Follow-up of a randomised trial with 184 of 227 eligible children (81%) assessed. The visual perception difference was a secondary outcome. The abstract does not say whether secondary results were adjusted for multiple comparisons. Only the abstract was read. - Last checked: Not recorded - Sources: 1. Supports: Mid-Childhood Outcomes after Dextrose Gel Treatment of Neonatal Hypoglycaemia: Follow-Up of the Sugar Babies Randomized Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentences 2 to 4. Retrieved 2026-10-14T18:24:00Z. Source state: Current. Snapshot hash: dceefa05b1c61bfdf1519053a4fdcfd0ec885d9c7e681446ed77f1360da7384d. How it applies: Educational achievement and visual perception results. 2. Background: Mid-Childhood Outcomes after Dextrose Gel Treatment of Neonatal Hypoglycaemia: Follow-Up of the Sugar Babies Randomized Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS and RESULTS sentence 1. Retrieved 2026-10-14T18:24:00Z. Source state: Current. Snapshot hash: dceefa05b1c61bfdf1519053a4fdcfd0ec885d9c7e681446ed77f1360da7384d. How it applies: Age at follow-up, primary outcome and numbers assessed. 3. Background: Mid-Childhood Outcomes after Dextrose Gel Treatment of Neonatal Hypoglycaemia: Follow-Up of the Sugar Babies Randomized Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSION, sentence 1. Retrieved 2026-10-14T18:24:00Z. Source state: Current. Snapshot hash: dceefa05b1c61bfdf1519053a4fdcfd0ec885d9c7e681446ed77f1360da7384d. How it applies: The authors' conclusion. ## Connected pages - Sugar Babies: less treatment failure than placebo gel: Low blood sugar in newborns (neonatal hypoglycaemia) (`maternal:neonatal-hypoglycaemia`) [a claim, not a settled fact; see claim `maternal:claim-sugar-babies-treatment-failure` and its context] - Mid-childhood follow-up of the Sugar Babies trial: Low blood sugar in newborns (neonatal hypoglycaemia) (`maternal:neonatal-hypoglycaemia`) [a claim, not a settled fact; see claim `maternal:claim-sugar-babies-midchildhood` and its context] - Filed under this front: Newborn support: warmth, breathing, feeding (`maternal:front-newborn-support`) ## Provenance Content hash: ec58b35a02a7086d9471fa38747498919f7a34b042d2cf09c387ae94aebd9df7 Last substantive edit: 2026-10-14 Evidence last checked: Not recorded