Effect of enteral administration of insulin on intestinal development and feeding tolerance in preterm infants: a pilot study

Arch Dis Child Fetal Neonatal Ed. 2002 Mar;86(2):F131-3. doi: 10.1136/fn.86.2.f131.


Objective: To determine in a pilot study whether enteral administration of insulin to preterm infants (26-29 weeks of gestational age) would enhance gastrointestinal development and reduce feed intolerance without adverse effects.

Design: Eight preterm infants were given 4 U/kg/day insulin enterally from 4 to 28 days of age. Lactase activity was measured at 28 days of age, while measures of feed intolerance were made throughout the hospital stay. The results were compared with those of a matched historical cohort of 80 preterm infants.

Setting: Tertiary care, university affiliated hospital.

Main outcome measures: Lactase activity and feed intolerance.

Results: No adverse effects, such as hypoglycaemia, were observed after administration of insulin. The infants who received insulin had higher lactase activity and less feed intolerance than the controls (30% shorter time to full enteral feeds; fewer gastric residuals per infant).

Conclusion: These preliminary data suggest that enteral insulin administration may be of benefit in reducing feed intolerance in preterm infants. A randomised, blinded trial is warranted.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Digestive System / drug effects
  • Digestive System / enzymology
  • Digestive System / growth & development*
  • Enteral Nutrition
  • Gastric Emptying / drug effects*
  • Humans
  • Infant Nutritional Physiological Phenomena / physiology*
  • Infant, Newborn
  • Infant, Premature / physiology*
  • Insulin / pharmacology*
  • Lactase
  • Pilot Projects
  • Time Factors
  • beta-Galactosidase / metabolism


  • Insulin
  • Lactase
  • beta-Galactosidase