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Glucose Infusion Rate (GIR) Calculator

Calculate the glucose infusion rate (GIR) in mg/kg/min from dextrose concentration, IV rate and weight, plus the rate for a target GIR, fluid in mL/kg/day and calories — for newborns and children.

Dextrose concentration

Infusion rate

Weight

Target GIR

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How it works

GIR (mg/kg/min) = dextrose % × rate (mL/h) ÷ (6 × weight kg) [= dextrose % × 10 mg/mL × rate ÷ 60 ÷ weight] · rate for a target = GIR × 6 × weight ÷ dextrose % · dextrose g/day = % ÷ 100 × mL/h × 24 · 3.4 kcal per g of dextrose monohydrate

The glucose infusion rate expresses how much glucose a baby or child receives per kilogram per minute, which is how neonatal teams compare IV regimens with the body’s own glucose production (about 4–6 mg/kg/min in a term newborn, 6–8 in preterm infants). A D10 solution contains 100 mg of glucose per mL; multiplying by the hourly rate and dividing by 60 minutes and the weight gives the GIR. Needs above about 8–10 mg/kg/min to keep glucose normal suggest hyperinsulinism. Concentrations above 12.5% dextrose are usually given through a central line because they irritate peripheral veins.

Worked example

A 3 kg newborn on D10 at 10 mL/h: GIR = 10 × 10 ÷ (6 × 3) = 5.56 mg/kg/min — within the usual 4–8 range. That is 24.0 g of dextrose and 80 mL/kg of fluid a day (27.2 kcal/kg/day). To reach a GIR of 6, the rate would be 6 × 6 × 3 ÷ 10 = 10.8 mL/h.

Sources: Adamkin DH; AAP Committee on Fetus and Newborn. Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics 2011;127:575–9 · Thornton PS et al. Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants and children. J Pediatr 2015;167:238–45

Frequently asked questions

What is a normal glucose infusion rate for a newborn?

Most term newborns need 4–6 mg/kg/min and preterm infants 6–8 mg/kg/min to match their own glucose production. A starting GIR of about 5–6 mg/kg/min (D10 at 80 mL/kg/day gives 5.6) is common.

How do I calculate GIR quickly?

GIR = dextrose % × mL/h ÷ (6 × kg). Example: D12.5 at 12 mL/h in a 2.5 kg baby = 12.5 × 12 ÷ 15 = 10 mg/kg/min.

When is a central line needed for dextrose?

Dextrose concentrations above 12.5% are generally given through a central line (umbilical venous catheter or PICC) because higher osmolality damages peripheral veins.

What does a high GIR requirement mean?

Needing more than about 8–10 mg/kg/min to keep blood glucose normal suggests hyperinsulinism (for example in infants of diabetic mothers) or another endocrine or metabolic cause and should prompt further investigation.

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Educational calculation for health professionals only, not medical advice or a prescription. Check every dose against the current product label, local protocols and a pharmacist, and adjust it for the individual patient.