title: Ontogeny of glucose homeostasis in low birth weight infants.
abstract: Suppression of the endogenous glucose production rate (Ra) is the adult response to glucose infusion. Persistent Ra (greater than or equal to 1 mg.kg-1min-1 or less than 80% decrease in basal Ra) in response to glucose infusion is evidence of a transitional homeostatic state in the neonate during the first days after birth. To determine whether postnatal development produces an adultlike response, Ra was measured in 11 infants (birth weight 1716 +/- 48 g, gestational age 33 +/- 0.3 weeks) at 2 to 5 weeks of age. In these paired studies, 4 micrograms.kg-1min-1 D-(U-13C)glucose tracer was infused by prime constant infusion to determine Ra, during infusion of either saline solution or glucose, the latter at a rate of 5.3 +/- 0.2 mg.kg-1min-1 (mean +/- SEM). When the results of the saline infusion turnover period were compared with those of the glucose infusion turnover period, plasma glucose concentration increased significantly, from 88 +/- 3 mg/dL to 101 +/- 4 mg/dL (P less than 0.001). Plasma insulin concentration remained unchanged (12 +/- 5 microU/mL vs 8 +/- 3 microU/mL). Ra was heterogenous during glucose infusion, and persistent Ra was present in six of 11 infants. Of the five infants who had decreased Ra during glucose infusion, three received glucose at a rate exceeding basal Ra. Of the remaining six infants who evidenced persistent Ra during glucose infusion, three received glucose at a rate equal to or in excess of basal Ra. We conclude that glucose homeostasis in low birth weight infants is transitional throughout the neonatal period.
authors.affiliation: Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence 02905-2401.
authors.forename: R M
authors.initials: RM
authors.lastname: Cowett
authors.forename: G E
authors.initials: GE
authors.lastname: Andersen
authors.forename: C A
authors.initials: CA
authors.lastname: Maguire
authors.forename: W
authors.initials: W
authors.lastname: Oh
mesh_terms: D000367:Age Factors; D001786:Blood Glucose / Q000096:biosynthesis / Q000378:metabolism*; D005947:Glucose / Q000008:administration & dosage; D006706:Homeostasis; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight / Q000378:metabolism*; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D005947:Glucose