Glucose Tolerance and Insulin Secretion in Very Small Babies

Abstract

and Jhchester. Nineteen exchange-transfusion were performed via he umbilical artery using blood preserved with aciditrate and dextrose in ei ht term /34-40 weeks gest-.tion/ and nine preterm /2%-33 weeks gestation, €350-.560 g body weight/ infants. Plasma lucose rise was mllar in both groups during t r a n s f f m~ 9327; l? 17+7 @I;/. The glucose disappearance vias 1,33+0,20 In eFm and l,4720,19 in prematures. Term infanTs respmded to glucose with a sharp rise in mean plasma in-,ulin /A 24+3 uU/ml/ which was seen three hours folloling the transfusion. /A 4122 uU/rd/. Insulin secret

The metabolic load of stored blood. Implications for major transfusions in infants.

“…A number of studies have illustrated the serious metabolic effects of individual substrates from transfused stored blood. [1][2][3] These effects may be modified, however, by other substrates present in abnormal quantities.…”

Preventive management of hypoglycemia in very low‐birthweight infants following indomethacin therapy for patent ductus arteriosus

“…Careful monitoring of blood glucose levels is essential to prevent against severe hypoglycemia. This therapeutic regimens of an increase in 2 mg/kg per min of glucose as a continuous infusion from the basal rate, which is approximately 6 mg/kg per min, is based on our previous study and several other reports 3,5–7 . Our recent study showed that the blood glucose values decreased from 96~32 mg/dL to 75~29 mg/dL during the first 12 h at the constant continuous glucose infusion of 3.56~0.98 mg/kg per min and approximately 50% of maximal reduction in glucose values in VLBW infants following indomethacin therapy during 96 h. A continuous glucose infusion rate that reached approximately 6 mg/kg per min stabilized the appropriate glucose level 3 .…”

“…Our recent study showed that the blood glucose values decreased from 96~32 mg/dL to 75~29 mg/dL during the first 12 h at the constant continuous glucose infusion of 3.56~0.98 mg/kg per min and approximately 50% of maximal reduction in glucose values in VLBW infants following indomethacin therapy during 96 h. A continuous glucose infusion rate that reached approximately 6 mg/kg per min stabilized the appropriate glucose level 3 . Several studies indicated that hyperglycemia in VLBW infants of lower birthweight and shorter gestations 5,6 is more likely to occur with glucose infusion rates exceeding 6 mg/kg per min 7–9…”

A C-Peptide-Based Model of Pancreatic Insulin Secretion in Extremely Preterm Neonates in Intensive Care

“…20 No differentiation of insulin secretion rates was seen between differing levels of protein or glucose intake in the neonates. This result is unexpected as an increase in plasma insulin concentrations in response to a glucose stimulus, [30][31][32][33][34] amino acids such as theophylline, 32,[35][36][37][38] and glucose priming 30 has been previously been observed in preterm infants. This discrepancy could be a result of differing study methodology and the more direct approach to estimating insulin secretion taken here.…”