Send to

Choose Destination
J Pediatr. 2011 Jun;158(6):891-6. doi: 10.1016/j.jpeds.2010.12.040. Epub 2011 Feb 15.

Gluconeogenesis is not regulated by either glucose or insulin in extremely low birth weight infants receiving total parenteral nutrition.

Author information

US Department of Agriculture Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.



To determine potential factors regulating gluconeogenesis (GNG) in extremely low birth weight infants receiving total parenteral nutrition.


Seven infants (birth weight, 0.824 ± 0.068 kg; gestational age, 25.4 ± 0.5 weeks; postnatal age, 3.3 ± 0.2 days) were studied for 11 hours, with parenteral lipid and amino acid therapy continued at prestudy rates. Glucose was supplied at prestudy rates for the first 5 hours (period 1) and was then reduced to 6 mg/kg·min for 1 hour and further to ~3 mg/kg·min for 5 hours (period 2). A total of 2.5 mg/kg·min of the glucose was replaced by [U-(13)C]glucose throughout the study for measurements of glucose production and GNG. Concentrations of glucose, insulin, glucagons, and cortisol were determined.


GNG and glucose production remained unchanged (2.12 ± 0.23 vs. 1.84 ± 0.25 mg/kg·min [P = NS] and 2.44 ± 0.27 vs. 2.51 ± 0.31 mg/kg·min [P = NS], respectively), despite a 60% reduction of the glucose infusion rate and subsequent 30% (124.7 ± 10.8 to 82.6 ± 8.9 mg/dL; P = .009) and 70% (26.9 ± 4.7 to 6.6 ± 0.4 μU/mL; P = .002) decreases in glucose and insulin concentrations, respectively. Cortisol and glucagon concentrations remained unchanged.


In extremely low birth weight infants receiving total parenteral nutrition, GNG is a continuous process that is not affected by infusion rates of glucose or concentrations of glucose or insulin.

Comment in

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center