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افزایش قند خون
Both hyperglycaemia and insulin use were associated with an increase in both severe (from 4% to 9%) and milder forms of retinopathy of prematurity.
Increasing nutrition alone seems to be insufficient to increase IGF-1 and promote postnatal weight gain in the early postnatal period in the most immature babies,95 and insufficient to decrease risk of retinopathy of prematurity.155 Instead, hyperglycaemia and insulin requirement are raised, both of which are associated with an increased risk.94 Since persistently low serum IGF-1 concentrations in preterm infants are associated with retinopathy of prematurity and other morbidities,45,156,157 and since supplemental IGF-1 seems to improve food utilisation in undernutrition,96 supplementation with exogenous IGF-1 might improve early postnatal growth and outcome.
Careful control of oxygen saturation, normalisation of serum IGF-1 concentrations, provision of adequate nutrition, minimisation of hyperglycaemia and insulin use, normalisation of ω-3 polyunsaturated fatty acid concentrations, and curbing the negative effects of infection and inflammation could promote adequate postnatal growth and improve neural and vascular development of the retina.
Hyperglycaemia, insulin, and nutrition
Raised neonatal glucose concentrations also increase the risk for retinopathy of prematurity.90-93 In a study94 of 372 infants born at a gestational age of less than 30 weeks, increased nutrition alone (without IGF-1 supplementation) caused hyperglycaemia, which required increased insulin use.
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