Effects of enteral insulin on enteral diet tolerance in premature infants: systematic review.

Objective: The primary objective of this systematic review was to evaluate the effect of enteral insulin supplementation provided to premature newborns on the time to achieve full enteral feeding. Secondary objectives included evaluating the effects on weight gain, the occurrence of adverse events, and mortality.

Data source: A systematic review of randomized clinical trials was conducted using the databases PubMed, Scientific Electronic Library Online (SciELO), clinicaltrials.gov, Embase, and Latin American and Caribbean Health Sciences Literature (Lilacs). The review was registered in PROSPERO under CRD42024523021. Premature newborns receiving enteral and parenteral nutrition who were given either breast milk or formula milk supplemented with enteral insulin as intervention, compared with placebo, were included. After applying the eligibility criteria, two articles were selected for this study.

Data synthesis: The two studies included in this review identified a reduced time to achieve full enteral feeding. Regarding secondary outcomes, there was a reduction in the number of days receiving parenteral nutrition and a reduction in adverse events and mortality. However, there was no agreement among the studies concerning weight gain.

Conclusions: Enteral insulin appears to be an effective treatment for reducing the time to achieve full enteral feeding. However, more studies are necessary to recommend its use in clinical practice.