Monitoring of early postnatal glucose homeostasis and cerebral function in newborn infants of diabetic mothers. A pilot study.
The aims of this pilot study were to evaluate a new technique in the monitoring of postnatal glucose homeostasis (microdialysis) and also to study possible associations between early postnatal hypoglycaemia and influences on cerebral function monitoring (CFM) in 12 newborn infants of diabetic mothers. In order to study the postnatal glucose homeostasis, frequent dialysate samples were obtained from a subcutaneous microdialysis catheter for measurements of glucose. In addition, we also received samples of dialysate lactate and glycerol. Dialysate glucose concentrations were correlated to capillary blood glucose levels, measured by a glucose oxidase method. The cerebral function monitor was applied postnatally and a registration was obtained continuously. Capillary blood glucose decreased initially, and seven newborns received intravenous glucose infusions due to glucose concentrations less than 2.2 mmol/l. Dialysate glucose concentrations were, on average, 0.4 mmol/l higher than corresponding concentrations in capillary blood. The correlation coefficient between the two measurements was 0.63 and the coefficient of variation was 19.2%. Dialysate lactate and glycerol levels increased significantly, with peak values 3-4 h postnatally. No significant overall influence of hypoglycaemia was detectable in the CFM tracing. We conclude that a relatively poor correlation was observed between glucose measurements in capillary samples and microdialysis. However, using the microdialysis technique saw indication of marked lipolysis and increased lactate production, which may be of importance for cerebral postnatal adaptation. The mild postnatal hypoglycaemia in infants of diabetic mothers does not seem to give visually detectable influences on CFM.
Stenninger
E
E
Department of Pediatrics, Orebro Medical Centre Hospital, S-701 85, Orebro, Sweden.
Eriksson
E
E
Stigfur
A
A
Schollin
J
J
Aman
J
J
D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D004569:Electroencephalography; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D005990:Glycerol / Q000032:analysis; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis*; D007231:Infant, Newborn / Q000378:metabolism*; D007262:Infusions, Intravenous; D019344:Lactic Acid / Q000032:analysis; D017551:Microdialysis / Q000379:methods; D008991:Monitoring, Physiologic; D010865:Pilot Projects; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*
D001786:Blood Glucose; D019344:Lactic Acid; D005947:Glucose; D005990:Glycerol