Insulin and growth-hormone responses in neonatal hyperglycemia

Abstract

Glucose, insulin and growth hormone values were studied prospectively in 75 premature infants during the first 5 days after birth. I.v. glucose was given at a mean rate of 4.7-4.9 mg/kg min-1 (range 3-7). Mean birth weight was 1394 .+-. 47 g (mean .+-. SEM). Blood glucose values were significantly higher on days 1 and 2 than on days 3-5. Hypoglycemia (blood glucose < 20 mg/100 ml) occurred in 2 SGA and 1 AGA infants. Hyperglycemia (> 125 mg/100 ml) was found in 32 of the 75 (42.7%) infants. A significantly greater number of deaths occurred in infants with hyperglycemia (19/32) than in those with normoglycemia (5/43). Mean plasma insulin values were significantly higher on days 1 and 2 (15 .+-. 3 and 18 .+-. 4 .mu.U[units]/ml) than on days 3 and 4-5 (6 .+-. 1 and 7 .+-. 2 .mu.U/ml). Mean insulin levels were significantly higher during hyperglycemic than during normoglycemic glucose levels at similar postnatal age. Growth hormone values were higher during the first 3 days than subsequently, but the values were similar in normoglycemic and hyperglycemic groups. Significant negative correlations were seen between glucose values on the first 2 days of postnatal life and birth weight, gestational age and Apgar scores, whereas positive correlations were found with FiO2 and respiratory distress score (RDS).