Glucose response to discontinuation of parenteral nutrition in patients less than 3 years of age.
BACKGROUND
The effects of abrupt discontinuation and tapering of total parenteral nutrition (TPN) on glucose concentration were compared in patients < 3 years of age.


METHODS
Serial glucose concentrations were measured over 120 minutes after abrupt discontinuation as compared with tapering (decreasing infusion rate by 50% for 1 hour before discontinuation). Serial insulin concentrations were measured after abrupt discontinuation.


RESULTS
There was a significantly greater decrease in glucose concentration from baseline at 30 minutes after abrupt discontinuation as compared with tapering. Fifty-five percent (6/11) of the patients developed hypoglycemia (glucose concentration < 40 mg/dL) after abrupt discontinuation. Age, glucose infusion rate, and serum insulin concentrations were not predictive of the development of hypoglycemia. The tapering regimen did not prevent hypoglycemia, which developed in 20% (2/10).


CONCLUSIONS
The high incidence of hypoglycemia after TPN discontinuation in children < 3 years of age requires monitoring of serum glucose concentration when initiating intermittent TPN until tolerance is documented.
Bendorf
K
K
Section of Gastroenterology and Nutrition Support, Children's Mercy Hospital, Kansas City, Missouri 64108, USA.
Friesen
C A
CA
Roberts
C C
CC
D001786:Blood Glucose / Q000378:metabolism; D002675:Child, Preschool; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007223:Infant; D007328:Insulin / Q000097:blood; D007700:Kinetics; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects* / Q000379:methods*
D001786:Blood Glucose; D007328:Insulin