Effect of diazoxide or glucagon on hepatic glucose production rate during extreme neonatal hypoglycaemia.
Open Access
- 1 September 1987
- journal article
- research article
- Published by BMJ in Archives of Disease in Childhood
- Vol. 62 (9), 924-930
- https://doi.org/10.1136/adc.62.9.924
Abstract
The relation between hepatic glucose production rate (HGPR) and plasma concentrations of insulin and glucagon was investigated in four term neonates who had severe hypoglycaemia. The hepatic glucose production rate was less than 20% of normal for fasting term neonates in all four babies and yet insulin concentrations were never greater than 12 microU/ml; two babies had very low glucagon concentrations (less than 60 ng/l). Two further neonates with similar histories also had plasma glucagon concentrations that were also extremely low (less than 20 ng/l). A single intravenous bolus of glucagon caused a rapid rise in hepatic glucose production rate towards the normal range, which was sustained for many hours after the bolus had been given. Diazoxide given to one baby suppressed previously 'normal' insulin concentrations still further (4.2 to less than 1.6 microU/ml) and thereby restored the hepatic glucose production rate to normal. In view of the normal plasma insulin concentrations at a time when the hepatic glucose production rate was reduced, we feel that the absolute concentration of insulin may be less important than the insulin/glucagon molar ratio in the control of glucose homeostasis in this group of infants. The changing of this ratio by means of boluses of glucagon may be useful in preventing rebound hypoglycaemia, which so often occurs when dextrose infusions are reduced either accidentally or in an attempt to restart oral feeds.This publication has 22 references indexed in Scilit:
- ITA, a portable program for the interactive analysis of data from tracer experimentsComputers in Biology and Medicine, 1985
- HYPERINSULINISM IN ASPHYXIATED AND SMALL-FOR-DATES INFANTS WITH HYPOGLYCAEMIAThe Lancet, 1984
- Persistent glucose production during glucose infusion in the neonate.JCI Insight, 1983
- The accurate determination of serum glucose by isotope dilution mass spectrometry—two methodsJournal of Mass Spectrometry, 1982
- Glucagon Deficiency Causing Severe Neonatal Hypoglycemia in a Patient with Normal Insulin SecretionPediatric Research, 1977
- Attenuated Glucose Production Rate in Newborn Infants of Insulin-Dependent Diabetic MothersNew England Journal of Medicine, 1977
- Increased Gluconeogenic Substrates in the Small-for-Gestational-Age InfantNew England Journal of Medicine, 1974
- Plasma glucagon levels in the term human infant and effect of hypoxiaArchives of Disease in Childhood, 1973
- INHIBITION OF INSULIN RELEASE BY DIPHENYLHYDANTOIN AND DIAZOXIDE IN A PATIENT WITH BENIGN INSULINOMAThe Lancet, 1973
- Effect of Diphenylhydantoin on Insulin Secretion in ManNew England Journal of Medicine, 1972