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Inhibition of glucagon secretion in the human newborn by glucose infusion
Insights
Glucose infusion suppresses infant glucagon secretion, but preterm infants show a weaker response. Insulin release to glucose is variable and often delayed in newborns.
Area of Science:
- Neonatology
- Endocrinology
- Pediatrics
Background:
- Understanding neonatal metabolic regulation is crucial for infant health.
- Hormonal responses to glucose in newborns are not fully characterized.
- Differences in glucose metabolism between term and preterm infants require investigation.
Purpose of the Study:
- To investigate plasma glucagon, serum insulin, and blood glucose responses to glucose infusion in term and preterm infants.
- To compare these hormonal responses on the first day of life versus the first week of life.
- To assess the impact of early extrauterine life on glucose homeostasis.
Main Methods:
- Studied 37 full-term and 35 preterm infants.
- Administered a 30-minute infusion of either glucose (1 g/kg body weight) or saline.
- Measured plasma glucagon, serum insulin, and blood glucose levels at baseline and during/after infusion.
Main Results:
- Glucose infusion rapidly suppressed glucagon secretion in all infants.
- Full-term infants exhibited greater maximal glucagon suppression (54-61%) compared to preterm infants (38-44%).
- Insulin response to glucose was variable and often delayed in both groups; saline infusion had no effect.
Conclusions:
- Neonatal glucagon secretion is sensitive to glucose, with term infants showing a more robust suppression.
- Preterm infants may have altered glucose-insulin-glucagon dynamics shortly after birth.
- Further research is needed to understand the clinical implications of these findings for infant metabolic health.
Abstract:
Plasma glucagon, serum insulin, and blood glucose responses during a 30-min glucose (1 g/kg body wt) or saline infusion were reported in 37 full-term and 35 preterm infants. They were studied either on the first day of life before feeding was initiated or during the first week of life. Glucose infusion promptly suppressed glucagon secretion in all infants even from the initial hours of extrauterine life. The mean maximal decrement in percentage in the full-term infants on the day of birth and older was 54 +/- 4% and 61 +/- 6%, respectively, while the maximal decrement in the preterm infants on day of birth and older was significantly lower (44 +/- 3% and 38 +/- 4%, respectively). The insulin response to glucose was variable in all infants and most of them showed a delayed rise of serum insulin. No change in plasma glucagon, blood glucose, and serum insulin was observed during and after saline infusion.