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CONSTANT GLUCOSE (G) INFUSION (CGI) AND SERUM INSULIN (I) CHANGES IN SEQUENTIALLY STUDIED PRETERM INFANTS

CGI as a stimulus in evaluating pancreatic β-cell responsiveness is considered superior to the bolus intravenous G tolerance test. This method was used to study the serum I changes in 14 pretenn infants at various stages of maturity and at different postnatal ages. G infusion rate was 9 mg/min/kg for 2 hrs. on day 1, and 6 mg/min/kg on days 7,14,21,28 and 35. Baseline G and I, half-hourly G, and hourly I levels were measured. CGI resulted in the following: on day 1, a steady state of G 30 mg% above baseline was achieved at 30 through 120 min. of the infusion. ΔI's (change in I from baseline) at 60 and 120 min. were 6.3 ± 2.6 μU/ml, p < .05 (M ± SEM), and 8.2 ± 2.2 μU/ml, p < .01, above a baseline of 7.3 ± 0.8 μU/ml. On days 7 and 14, G rose at 30 and 60 min. but fell at 90 and 120 min. I at 120 min. was significantly less (0.7 ± 0.7 μU/ml, p < .001) than the corresponding day 1 value. After 21 days, no significant increase in G was seen during the CGI. The ΔI's at 60 and 120 min. were significantly less than on day 1 (-1.2 ± 1.4, p < .02 and -3.2 ± 1.2 μU/ml, p < .02). The G and I changes seen in relation to postnatal age were independent of gestational age.These data indicate that G utilization by preterm infants is proportional to postnatal age and that the serum I changes during CGI are proportional to the G levels.