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Glucose metabolism and insulin secretion in infants with symptomatic ventricular septal defect

K H Lundell1, K G Sabel, B O Eriksson

  • 1Department of Paediatrics, Central Hospital of Jönköping, Gothenburg, Sweden.

Acta Paediatrica Scandinavica
|July 1, 1989
PubMed

Insights

Infants with symptomatic ventricular septal defect (VSD) show normal glucose tolerance but have altered insulin responses. Despite higher insulin secretion, circulating insulin levels are lower, suggesting increased insulin binding or liver extraction.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Cardiology

Background:

  • Symptomatic infants with ventricular septal defect (VSD) often exhibit growth retardation.
  • Metabolic alterations, particularly glucose and insulin metabolism, may be associated with VSD.

Purpose of the Study:

  • To investigate glucose tolerance and insulin secretion in infants with symptomatic VSD.
  • To compare metabolic profiles between VSD infants and healthy controls.

Main Methods:

  • Intravenous glucose tolerance test (IVGTT) performed on 19 infants with symptomatic VSD and 14 healthy infants.
  • Plasma glucose, insulin, and C-peptide levels were measured.
  • Insulin secretion rate calculated from C-peptide levels.

Main Results:

  • VSD infants were growth retarded but demonstrated normal glucose tolerance, including fasting glucose and glucose disappearance rate.
  • Insulin levels in plasma were significantly lower in VSD infants post-glucose load.
  • Calculated insulin secretion rate was significantly elevated in VSD infants compared to controls.

Conclusions:

  • Infants with symptomatic VSD maintain normal glucose tolerance despite growth deficits.
  • VSD is associated with an increased insulin secretion rate but decreased circulating insulin levels.
  • This discrepancy suggests enhanced insulin binding to peripheral receptors or increased hepatic insulin extraction in VSD infants.

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