Glucose metabolism in the infant weighing less than 1100 grams☆,☆☆,★,★★
Section snippets
Subjects
Ten infants (five girls) appropriate in size for gestational age and with birth weights <1100 gm, who were patients in the intensive care nursery at Temple University Hospital, Philadelphia, Pa., were recruited for this study. In addition to birth weight, selection criteria included (1) hemodynamic stability (i.e., normal and stable blood pressure, good peripheral perfusion), (2) if an endotracheal tube was in place, the need for low levels of mechanical ventilatory support (defined as a peak
RESULTS
Data from the 60- and 120-minute periods are presented in Table I. Mean plasma insulin concentration at 120 minutes was 71.4 pmol/L and ranged from 21.5 to 114 pmol/L. Plasma glucose concentrations and 6,6,-2H-glucose enrichment did not change throughout the study period (Fig. 1).
Correlations between the measured and calculated variables at 120 minutes are presented in Table II. Endogenous production of glucose was correlated with the plasma glucose concentration (r = .076) and GRd (r = 0.75),
DISCUSSION
Using a stable-isotope tracer method, we investigated EGP and GRd in clinically stable <1100 gm infants. The average GRd of 37 μmol/kg (6.77 mg/kg) per minute was higher than any previously reported values for larger and more mature infants. Using glucose uniformly labeled with carbon 13 as tracer, Cowett et al.7 reported a GRd of 16.6 μmol/kg (3 mg/kg) per minute (range, 10 to 22.8 μmol/kg [1.8 to 4.1 mg/kg] per minute) in ten 2000 gm infants born at 34 weeks of gestation, who were studied
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Glucose metabolism in the preterm infant
2011, Journal of PediatricsGluconeogenesis is not regulated by either glucose or insulin in extremely low birth weight infants receiving total parenteral nutrition
2011, Journal of PediatricsCitation Excerpt :During the first 5 hours of the study, glucose was given at the prestudy rate (8.4 ± 0.5 mg/kg·min; range, 6.9 to 10.0 mg/kg·min, corresponding to 10.0 to 14.4 g/kg·day) (designated period 1). At study hour 5 (directly after a 5-hour blood sample), the glucose infusion rate was reduced stepwise (to minimize counterregulatory responses), first to 6 mg/kg·min (corresponding to the normal glucose turnover rate in newborn infants2-8) for 1 hour and then further to 3.4 ± 0.2 mg/kg·min (range, 2.9 to 4.1 mg/kg·min) for the remaining 5 hours of the 11-hour study period (designated period 2). During the entire 11-hour study period, 2.5 ± 0.1 mg/kg·min of the foregoing glucose infusion rates was replaced by [U-13C]glucose (metabolically equivalent to unlabeled natural glucose and used to measure the glucose appearance rate [Ra] and glucose production from GNG and glycogenolysis).
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From the Departments of Pediatrics and Internal Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
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Supported by U.S. Public Health Service grants AG-07988 (G. Boden) and RR-349 (General Clinical Research Center) and a Clinical Research Grant from the American Diabetes Association (G. Boden)
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Reprint requests: Eileen E. Tyrala, MD, Temple University Hospital, Broad and Ontario Streets, Philadelphia, PA 19140-5189.
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