PT  - JOURNAL ARTICLE
AU  - Emma R Salis
AU  - David M Reith
AU  - Benjamin J Wheeler
AU  - Roland S Broadbent
AU  - Natalie J Medlicott
TI  - Insulin resistance, glucagon-like peptide-1 and factors influencing glucose homeostasis in neonates
AID  - 10.1136/archdischild-2015-309174
DP  - 2017 Mar 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - F162--F166
VI  - 102
IP  - 2
4099  - http://fn.bmj.com/content/102/2/F162.short
4100  - http://fn.bmj.com/content/102/2/F162.full
SO  - Arch Dis Child Fetal Neonatal Ed2017 Mar 01; 102
AB  - Objectives To explore the relationships between postmenstrual age (PMA), insulin, C-peptide, glucagon and blood glucose concentrations (BGCs) in preterm and term neonates. To compare glucagon-like peptide-1 (GLP-1) concentrations in fed versus never-fed neonates.Design Observational.Setting Dunedin Hospital Neonatal Intensive Care Unit, New Zealand.Patients Term or preterm euglycaemic neonates (102) receiving routine blood tests (343 samples).Interventions None: plasma was obtained from surplus samples from routine clinical care.Main outcome measures Insulin, C-peptide, GLP-1 and glucagon concentrations were measured in temporal association with BGC.Results Insulin and C-peptide concentrations were elevated in very preterm infants (PMA≤32 weeks) and decreased to term; this relationship persisted when BGCs were accounted for. Generalised linear mixed models showed that insulin:C-peptide ratio and insulin:BGC ratio decreased significantly with increasing PMA (p<0.001). GLP-1 increased following initial oral feeds regardless of PMA (p<0.001).Conclusion Preterm neonates exhibit insulin resistance in the absence of hyperglycaemia. Enteral feeds result in an increase in GLP-1. These factors are likely to contribute to the increased risk of hyperglycaemia in premature neonates (PMA<32 weeks).