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Glucose kinetics in glucose-infused small for gestational age infants
Insights
Small for gestational age (SGA) neonates show normal glucose homeostasis and hormonal responses when receiving glucose infusion. This indicates functional integrity in glucose handling similar to appropriate for gestational age infants.
Area of Science:
- Neonatal physiology
- Endocrinology
- Metabolic research
Background:
- Glucose homeostasis is critical for neonatal adaptation.
- Small for gestational age (SGA) infants may have altered metabolic profiles.
- Understanding glucose metabolism in SGA neonates is essential for clinical management.
Purpose of the Study:
- To assess glucose kinetics and homeostasis in SGA neonates.
- To compare glucose metabolism between SGA and appropriate for gestational age (AGA) infants.
- To evaluate hormonal regulatory responses to glucose infusion in neonates.
Main Methods:
- Utilized D-[U-13C]glucose tracer with prime plus constant infusion technique.
- Measured glucose kinetics, plasma glucose, insulin, and glucagon concentrations.
- Compared SGA infants with term and preterm AGA infants.
Main Results:
- SGA and AGA infants exhibited similar plasma glucose levels during infusion.
- Plasma insulin and glucagon concentrations were comparable between SGA and AGA groups.
- Persistent rates of glucose production were similar in all infant groups studied.
Conclusions:
- SGA neonates demonstrate functional integrity in glucose handling.
- Hormonal regulatory responses to glucose infusion are similar in SGA and AGA infants.
- Neonatal glucose homeostasis matures similarly in SGA and AGA infants by the second day of life.
Abstract:
To evaluate the maturation of glucose homeostasis in the small for gestational age (SGA) neonate, glucose kinetics were measured with 78% enriched D-[U-13C]glucose by the prime plus constant infusion technique in nine SGA infants and compared with the rate obtained in seven term appropriate for gestational age infants and 13 preterm appropriate for gestational age infants. All of the infants had received glucose intravenously from birth and continued to receive the glucose infusion throughout the study. Fasting plasma glucose and plasma insulin concentrations and plasma [13/12C]ratios were measured during the steady state turnover period. From this data, the glucose production rate was derived. During the turnover period, the SGA and both groups of appropriate for gestational age infants had similar average plasma glucose, plasma insulin, plasma glucagon concentrations, and similar persistent rates of glucose production during glucose infusion. We conclude that under stimulation of glucose infusion, the SGA infant and his AGA counterpart have similar hormonal regulatory responses as well as functional integrity in handling glucose during the second day after birth.