PEDIATRICS Vol. 63 No. 3 March 1979, pp. 389-396
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Glucose Disposal of Low Birth Weight Infants: Steady State Hyperglycemia Produced by Constant Intravenous Glucose Infusion

Richard M. Cowett M.D.1, William Oh M.D.1, Arnold Pollak M.D.1, Robert Schwartz M.D.1, and Barbara S. Stonestreet M.D.1

1 Department of Pediatrics, Women and Infants Hospital of Rhode Island, and the Rhode Island Hospital, Division of Reproductive and Developmental Medicine, Brown University Program in Medicine, Providence

Tolerance for glucose was studied in 35 well, appropriate for gestational age, low birth weight (LBW) infants (mean birth weight, 1,216 gm; mean gestational age, 30 weeks) between 3 and 38 days of age. Infants were given a graded dose of glucose at 8.1, 11.2, or 14.0 mg/kg/min for three hours by continuous peripheral intravenous infusion. Plasma glucose and insulin, and timed urine glucose and volume were measured. A steady state of plasma glucose concentration was noted by one hour at all infusion rates. In the nine infants receiving 8.1 mg/kg/min, plasma glucose and insulin were similar to the baseline values during the steady state, and none of these infants evidenced glucosuria. In the 16 infants receiving 11.2 mg/kg/min, the plasma glucose concentration significantly increased (140 to 166 mg/dl) during the steady state but the plasma insulin levels were not significantly different compared to baseline. Half of these infants developed hyperglycemia (plasma glucose 150 mg/dl) and glucosuria. Ten infants receiving 14.0 mg/kg/min developed a significantly higher plasma glucose and plasma insulin response in colmparison to those infants who received 8.1 and 11.2 mg/kg/min, and all evidenced hyperglycemia and glucosuria. Glucosuria did not exceed 6.4 mg/kg/hr (0.1 mg/kg/min) so that glucose disposal (retention) exceeded 99% of intake, and an osmotic diuresis was not noted in those infants who had glucosuria. Our data suggested that in well LBW infants, a three-hour infusion of glucose up to 14.0 mg/kg/min (approximately 80 kcal/kg/day) did not produce an osmotic diuresis, but in the highest infusion group (14 mg/kg/min), hyperglycemia did occur. The effect of hyperglycemia in the neonate is unknown and needs to be investigated.

Submitted on May 15, 1978
Accepted on August 4, 1978




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