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Developmental disorders of glucose metabolism in infants

R Hume1, A McGeechan, A Burchell

  • 1Department of Child Health, Obstetrics and Gynaecology, Tayside Institute of Child Health, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK. r.hume@dundee.ac.uk

Child: Care, Health and Development
|January 8, 2003
PubMed

Insights

Preterm infants show a significantly different response to glucagon tolerance tests compared to adults, indicating potential challenges in regulating blood glucose levels. This study adapted the test for neonates, revealing an attenuated glucose increase, likely due to lower hepatic glucose-6-phosphatase activity.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Pediatric Metabolism

Background:

  • Postnatal blood glucose control is a common challenge in newborns, persisting for months.
  • The glucagon tolerance test is the standard method for assessing hepatic glucose production.

Purpose of the Study:

  • To adapt the standard glucagon tolerance test for use in preterm infants.
  • To evaluate the glucose response to glucagon in preterm infants.

Main Methods:

  • Adapted the standard glucagon tolerance test for preterm infants.
  • Recruited 79 preterm infants (25-36 weeks gestational age) admitted to the Neonatal Intensive Care Unit.
  • Administered the test at discharge home.

Main Results:

  • The maximal plasma glucose increase in preterm infants was 1.39 +/- 0.07 mmol/L (range 0-3.98 mmol/L).
  • This response is significantly lower than the abnormal threshold of <4 mmol/L seen in adults.

Conclusions:

  • Preterm infants exhibit an attenuated response to glucagon compared to adults.
  • This difference is likely due to lower hepatic glucose-6-phosphatase activity in preterm infants.
  • Hepatic glucose-6-phosphatase is crucial for liver glucose production pathways.
Abstract

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