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Novel Insights from Clinical Practice

Severe Hypoinsulinaemic Hypoglycaemia in a Premature Infant Associated with Poor Weight Gain and Reduced Adipose Tissue

Coelho R.a · Wells J.b · Symth J.d · Semple R.e · O'Rahilly S.e · Eaton S.c · Hussain K.a

Author affiliations

Departments of aEndocrinology, bNutrition and cSurgery, Great Ormond Street Hospital for Children NHS Trust and the Institute of Child Health, University College London, London, dTrevor Mann Baby Unit, Department of Women and Children’s Health, Royal Sussex County Hospital, Brighton, and eDepartment of Clinical Biochemistry, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK

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Horm Res 2007;68:91–98

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Article / Publication Details

First-Page Preview
Abstract of Novel Insights from Clinical Practice

Received: September 29, 2006
Accepted: January 17, 2007
Published online: March 21, 2007
Issue release date: July 2007

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 5

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: https://www.karger.com/HRP

Abstract

Background: Hypoglycaemia is common in preterm and intrauterine growth retarded (IUGR) newborns. Although preterm and IUGR infants have limited adipose tissue stores, the role of adipose tissue and the associated adipocytokines in glucose physiology is not known. Aim: We report the case of a premature intrauterine growth retarded infant who had poor weight gain for the first 6 weeks of life and then developed severe hypoinsulinaemic hypoketotic hypoglycaemia. Results: There was markedly reduced adiposity with low serum leptin and adiponectin levels. Total energy expenditure and body composition measurements showed that body fat as a percentage of weight averaged 7% at 20 weeks and 28% at 28 weeks. At 20 weeks of age, the patient was equivalent to a deficit of >2 SD scores of body fat, but average fatness by 28 weeks. The hypoglycaemia completely resolved when the patient started gaining weight with an increase in fat mass and a concomitant increase in serum leptin and adiponectin level. Conclusions: Although the precise mechanism of this patient’s severe hypoglycaemia is unclear, further studies are required to understand the role of adipose tissue and adipocytokines in glucose homeostasis in preterm and IUGR infants.

© 2007 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Novel Insights from Clinical Practice

Received: September 29, 2006
Accepted: January 17, 2007
Published online: March 21, 2007
Issue release date: July 2007

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 5

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: https://www.karger.com/HRP


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