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Insulin and growth-hormone responses in neonatal hyperglycemia
Insights
Hyperglycemia in premature infants is common and linked to higher mortality. Insulin levels are elevated during hyperglycemia, while growth hormone levels are not significantly different between hyperglycemic and normoglycemic infants.
Area of Science:
- Neonatalogy
- Endocrinology
- Metabolic Disorders
Background:
- Premature infants exhibit unique metabolic challenges in the early postnatal period.
- Understanding glucose, insulin, and growth hormone dynamics is crucial for neonatal care.
Purpose of the Study:
- To prospectively investigate glucose, insulin, and growth hormone levels in premature infants during the first five days of life.
- To identify the incidence of hypoglycemia and hyperglycemia and their correlation with clinical outcomes.
Main Methods:
- Prospective study of 75 premature infants.
- Measurement of blood glucose, plasma insulin, and growth hormone levels.
- Analysis of correlations with birth weight, gestational age, and clinical parameters.
Main Results:
- Blood glucose levels were higher in the first two days post-birth.
- Hyperglycemia ( > 125 mg/100 ml) occurred in 42.7% of infants, associated with increased mortality.
- Insulin levels were higher during hyperglycemia and in the first two days of life.
- Growth hormone levels were similar between normoglycemic and hyperglycemic groups.
Conclusions:
- Hyperglycemia is a significant issue in premature infants with increased mortality risk.
- Elevated insulin levels accompany hyperglycemia in this population.
- Further research is needed to optimize glucose management in premature neonates.
Abstract:
Glucose, insulin, and growth hormone values were studied prospectively in 75 premature infants during the first five days after birth. Intravenous glucose was given at a mean rate of 4.7-4.9 mg./kg./min. (range 3-7). Mean birth weight was 1,394+/-47 gm. (mean+/-S.E.M.). Blood glucose values were significantly higher on days 1 and 2 than on days 3 to 5. Hypoglycemia (blood glucose less than 20 mg./100 ml.) occurred in two SGA and one AGA infants. On the other hand, hyperglycemia (greater than 125 mg./100 ml.) was found in 32 of the 75 (42.7 per cent) infants. A significantly greater number of deaths occurred in infants with hyperglycemia (19/32) than in those with normoglycemia (19/32) than in those with normoglycemia (5/43). Mean plasma insulin values were significantly higher on days 1 and 2 (15+/-3 and 18+/-4 muU./ml.) than on days 3 and 4-5 (6+/-1 and 7+/-2 muU./ml.). In addition, mean insulin levels were significantly higher during hyperglycemic than during normoglycemic glucose levels at similar postnatal age. Growth hormone values were higher during the first three days than subsequently, but the values were similar in normoglycemic and hyperglycemic groups. Significant negative correlations were seen between glucose values on the first two days of postnatal life and birth weight, gestational age, and Apgar scores, whereas positive correlations were found with FiO2 and respiratory distress score (RDS).