Glucose metabolism in a term infant with transient hyperinsulinism and high carbohydrate intake.
Transient hyperinsulinaemia is a well-known cause of hypoglycaemia in newborn infants. The hypoglycaemia may be caused by a decreased glucose production and/or an increased glucose uptake. Whether the increased uptake is caused by increased glucose oxidation or increased non-oxidative disposal is not known. The aim of this study was to investigate the fate of the large amount of glucose infused in a term infant who developed hypoglycaemia due to transient hyperinsulinaemia shortly after birth and was treated with high glucose infusions. On day 6 an indirect calorimetry study was performed, together with a glucose turnover study. Carbohydrate intake was 13.6 mg/kg per minute (19.6 g/kg per day). Both studies were repeated on day 11, when carbohydrate intake was normalised to 7.8 mg/kg per minute (11.2 g/kg per day). Glucose oxidation was 28% higher and non-oxidative glucose disposal was 257% higher on day 6 as compared to day 11. Our results indicate that hypoglycaemia during hyperinsulinism is the result of increased non-oxidative disposal of glucose and not increased glucose oxidation. The results indicate a remarkable capacity of the newborn for lipogenesis during high carbohydrate intake.
van Goudoever
J B
JB
Department of Paediatrics, Sophia Childrens Hospital, Rotterdam, The Netherlands.
Sulkers
E J
EJ
Kalhan
S C
SC
Sauer
P J
PJ
D000273:Adipose Tissue / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D002153:Calorimetry, Indirect; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood*; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D010084:Oxidation-Reduction; D013997:Time Factors
D001786:Blood Glucose; D005947:Glucose