TY - JOUR T1 - Insulin resistance, glucagon-like peptide-1 and factors influencing glucose homeostasis in neonates JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - F162 LP - F166 DO - 10.1136/archdischild-2015-309174 VL - 102 IS - 2 AU - Emma R Salis AU - David M Reith AU - Benjamin J Wheeler AU - Roland S Broadbent AU - Natalie J Medlicott Y1 - 2017/03/01 UR - http://fn.bmj.com/content/102/2/F162.abstract N2 - 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). ER -