Glucose kinetics in infants of diabetic mothers

Abstract

Glucose kinetic studies were performed to define the glucose turnover rate with 78% enrichedd-[U-13C] glucose by the prime constant infusion technique at ≤6 hours of age in nine infants of diabetic mothers (four insulin-dependent and five chemical diabetic patients) at term. Five normal infants were studied as control subjects. All infants received 0.9% saline intravenously during the study with the tracer. Fasting plasma glucose, insulin, and 13/12C ratios were measured during the steady state, and the glucose turnover rate was derived. The average plasma glucose concentration was similar during the steady state in the infants of the diabetic mothers and in the control infants, and the glucose turnover rate was not significantly different among the groups: 2.3 ± 0.6 mg · kg−1min−1 in infants of insulin-dependent diabetic patients; 2.4 ± 0.4 mg · kg−1min−1 in infants of chemical diabetic patients; and 3.2 ± 0.3 mg · kg−1min−1 in the control subjects. Good control of maternal diabetes evidenced by the normal maternal hemoglobin A1C and plasma glucose concentration at delivery and cord plasma glucose concentration resulted in glucose kinetic values in the infants of diabetic mothers that were indistinguishable from those of control subjects. The data further support the importance of good control of the diabetic state in the pregnant woman to minimize or prevent neonatal hypoglycemia.