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Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice
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Published on: November 16, 2011

Both relative insulin resistance and defective islet beta-cell processing of proinsulin are responsible for transient

Delphine Mitanchez-Mokhtari1, Najiba Lahlou, François Kieffer

  • 1Service de Réanimation Pédiatrique et Néonatale, Hôpital Necker-Enfants Malades, Paris, France. delphine.mitanchez@nck.ap-hop-paris.fr

Pediatrics
|March 3, 2004
PubMed

Insights

Extremely preterm infants with hyperglycemia show defective proinsulin processing and insulin resistance. Insulin infusion effectively lowers glucose levels in these neonates.

Area of Science:

  • Neonatalogy
  • Endocrinology
  • Metabolic Disorders

Background:

  • Extremely preterm infants frequently experience hyperglycemia during neonatal intensive care.
  • The underlying mechanisms of transient hyperglycemia in this population are not fully understood.

Purpose of the Study:

  • To investigate whether defective insulin secretion or insulin resistance is the primary cause of transient hyperglycemia in extremely preterm infants.
  • To evaluate beta-cell peptide levels and insulin sensitivity in hyperglycemic preterm neonates.

Main Methods:

  • A prospective comparative study involving three groups: hyperglycemic preterm infants, normoglycemic preterm infants, and term neonates.
  • Serum proinsulin, insulin, and C-peptide levels were measured using specific immunoassays.
  • Changes in beta-cell peptide levels were analyzed during and after intravenous insulin infusion in hyperglycemic infants.

Main Results:

  • Hyperglycemic preterm infants had significantly higher proinsulin concentrations compared to controls.
  • Proinsulin and C-peptide levels were elevated in normoglycemic preterm infants versus term neonates.
  • Insulin infusion in hyperglycemic neonates led to decreased plasma glucose, proinsulin, and C-peptide levels.

Conclusions:

  • Preterm neonates exhibit impaired proinsulin processing to insulin during hyperglycemia.
  • Hyperglycemic preterm infants demonstrate relative insulin resistance, requiring higher insulin levels for euglycemia.
  • Intravenous insulin infusion is a beneficial treatment for transient hyperglycemia in extremely preterm infants.
Abstract

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