Lower insulin secretory response to glucose induced by artificial nutrition in children: prolonged and total parenteral nutrition.
Long-term parenteral nutrition (TPN) in children is associated with sustained hyperinsulinemia due to a high nutriment infusion flow 12 h/24 h, with plausible lipotoxicity secondary to repeated lipid infusions and with changes in incretin hormone release. The aim of this study was to test whether long-term TPN can lead to an alteration in beta-cell function. Thirteen children (age 9.5 +/- 3.9 y) on total TPN without obvious alternation in glucose tolerance were included. beta-Cell function was quantified with an intravenous glucose tolerance test (IVGTT) and a graded glucose infusion. First phase insulin release (FPIR) was low in five patients. The same demonstrated a lower insulin release under graded glucose infusion, although plasma glucose reached values as high as 15 mM. These data emphasize that metabolic conditions induced by TPN can lead to lower insulin secretory response to glucose. Patients who remain dependent on TPN are at risk of developing glucose tolerance disorders.
Beltrand
Jacques
J
INSERM, U690, Paris, 75019, France. Jacques.beltrand@rdebre.inserm.fr
Colomb
Virginie
V
Marinier
Evelyne
E
Daubrosse
Christelle
C
Alison
Marianne
M
Burcelin
Rémi
R
Cani
Patrice D
PD
Chevenne
Didier
D
Marchal
Claire Lévy
CL
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism*; D015309:Glucose Clamp Technique; D044882:Glucose Metabolism Disorders / Q000097:blood / Q000209:etiology* / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects*; D013997:Time Factors