In contrast to the adult the neonate has persistent glucose
production and greater peripheral sensitivity to insulin.
Farrag, Hussien M., Lynn M. Nawrath, Jane E. Healey, Elizabeth J.
Dorcus, Robert E. Rapoza, William Oh, Richard M. Cowett.
Department of Pediatrics, Brown University School of Medicine,
Providence, Rhode Island and Women & Infants Hospital of Rhode
Island, Providence, Rhode Island
APStracts 3:0174E, 1996.
Insulin resistance has been reported to partially explain the clinical
appearance of neonatal hyperglycemia. To determine the relative
resistance of glucose production vs. glucose utilization to insulin,
the euglycemic hyperinsulinemic clamp technique was employed for the
first time in the human neonate and was combined with stable isotopic
determination of glucose production and glucose utilization. The
basal rates of glucose production and glucose utilization were
determined following which each neonate was clamped at his/her own
euglycemic glucose concentration while receiving regular human
insulin at one rate of 0.2, 0.5, 1.0, 2.0 or 4.0 mU_kg-1min-1.
Persistent glucose production (>/= 1 mg_kg-1min-1) during the clamp
was recorded for all groups. A significant increase in the glucose
infusion rate (p<0.001) and in percent glucose utilization
(p<0.01) occurred in the 2.0 and 4.0 mU_kg-1min1 insulin groups.
Metabolic clearance rate of insulin was significantly greater in the
neonate when compared to the adult at 2.0 mU_kg-1min-1 insulin
infusion rate (p=0.036). Our results indicate that in contrast to the
adult, the neonate has persistent glucose production (p=0.001) and
greater peripheral sensitivity to insulin (p=0.015).
Received 16 January 1996; accepted in final form 26 July 1996.
APS Manuscript Number E24-6.
Article publication pending Am. J. Physiol. (Endocrinol. Metab.).
ISSN 1080-4757 Copyright 1996 The American Physiological Society.
Published in APStracts on 29 August 1996