title: Glucose response to discontinuation of parenteral nutrition in patients less than 3 years of age.
abstract: 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.
authors.affiliation: Section of Gastroenterology and Nutrition Support, Children's Mercy Hospital, Kansas City, Missouri 64108, USA.
authors.forename: K
authors.initials: K
authors.lastname: Bendorf
authors.forename: C A
authors.initials: CA
authors.lastname: Friesen
authors.forename: C C
authors.initials: CC
authors.lastname: Roberts
mesh_terms: 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*
chemical_list: D001786:Blood Glucose; D007328:Insulin