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Gastrointestinal enhanced insulin release in response to glucose in newborn infants
Insights
Newborn infants show enhanced insulin response after gastrointestinal (GI) glucose administration, but only when blood sugar levels exceed a certain threshold. This suggests the enteroinsular axis is active shortly after birth.
Area of Science:
- Neonatology
- Endocrinology
- Pediatric Metabolism
Background:
- The enteroinsular axis, which regulates insulin secretion in response to nutrient intake, is crucial for glucose homeostasis.
- Understanding its function in newborns is vital for managing infant metabolism and potential endocrine disorders.
Purpose of the Study:
- To investigate the presence and conditions of gastrointestinal (GI) enhanced insulin response in newborn infants shortly after birth.
- To determine if the route of glucose administration (intravenous vs. orogastric) affects insulin secretion in neonates.
Main Methods:
- Studied 30 term newborns (categorized by gestational age and maternal diabetes status).
- Administered glucose via intravenous or orogastric routes to achieve similar plasma glucose concentrations (approx. 110 mg/dl).
- Compared plasma insulin responses between the two administration routes.
Main Results:
- Infants receiving glucose via the GI (orogastric) route exhibited significantly greater plasma insulin responses compared to those receiving it intravenously.
- This enhanced insulin release was observed when plasma glucose concentrations exceeded a specific threshold.
- Results contrast with previous findings, indicating a threshold-dependent GI insulin enhancement.
Conclusions:
- The enteroinsular axis is functional in term newborns soon after birth.
- GI-enhanced insulin release in neonates is dependent on achieving a threshold plasma glucose concentration.
- These findings have implications for understanding neonatal glucose metabolism and endocrine function.
Abstract:
The purpose of this investigation was to determine whether or not gastrointestinal (GI) enhanced insulin response occurs in newborn infants soon after birth. Glucose infusion by intravenous or orogastric routes was given to infants during the first 4 days of life, aiming at achieving similar plasma glucose concentrations. Their plasma insulin responses were then compared. Thirty term, newborn infants (10 appropriate for gestational age, 8 small for gestational age, 6 large for gestational age, and 6 infants of diabetic mothers) were studied. With intravenous glucose infusions of 8 mg/kg/min or orogastric infusion of 16 mg/kg/min, the plasma glucose concentrations achieved were similar and approximated 110 mg/dl. Plasma insulin responses were greater in infants receiving glucose via the GI route. The finding was in contrast to our previous data, in which no GI enhancement of insulin response was demonstrated. The present data suggest that in the term newborn infant, GI enhanced insulin release occurs only when a threshold of plasma glucose concentration has been exceeded. It appears that the enteroinsular axis is functional in newborns soon after birth.