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C-Peptide Suppression during Insulin Infusion in the Extremely Preterm Infant Is Associated with Insulin Sensitivity

Hellström, William ; Hansen-Pupp, Ingrid LU ; Hellgren, Gunnel ; Engström, Eva ; Stigson, Lennart ; Sävman, Karin ; Ley, David LU and Löfqvist, Chatarina (2019) In Journal of Clinical Endocrinology and Metabolism 104(9). p.3902-3910
Abstract

Context: Little is known about the individual response of glucose-regulating factors to administration of exogenous insulin infusion in extremely preterm infants. Objective: To evaluate longitudinal serum concentrations of insulin, C-peptide, and plasma glucose levels in a high-frequency sampling regimen in extremely preterm infants treated with insulin because of hyperglycemia. Design: Prospective longitudinal cohort study. Setting: Two university hospitals in Sweden between December 2015 and September 2016. Patients and Intervention: Serum samples were obtained from nine extremely preterm infants, gestational age between 22 (+3) and 26 (+5) weeks (+ days), with hyperglycemia (plasma-glucose >10 mmol/L) at the start of insulin... (More)

Context: Little is known about the individual response of glucose-regulating factors to administration of exogenous insulin infusion in extremely preterm infants. Objective: To evaluate longitudinal serum concentrations of insulin, C-peptide, and plasma glucose levels in a high-frequency sampling regimen in extremely preterm infants treated with insulin because of hyperglycemia. Design: Prospective longitudinal cohort study. Setting: Two university hospitals in Sweden between December 2015 and September 2016. Patients and Intervention: Serum samples were obtained from nine extremely preterm infants, gestational age between 22 (+3) and 26 (+5) weeks (+ days), with hyperglycemia (plasma-glucose >10 mmol/L) at the start of insulin infusion, at 12, 24, and every 24 hours thereafter during ongoing infusion, and 12, 24, and 72 hours after the end of insulin infusion. Main outcome measures: Longitudinal serum concentrations of insulin and C-peptide and plasma glucose levels. Results: During insulin infusion, the serum C-peptide concentrations decreased compared with at start of infusion (P = 0.036), and then increased after ending the infusion. Individual insulin sensitivity based on the nonfasting plasma glucose/insulin ratio at the start of insulin infusion correlated with the initial decrease in serum ΔC-peptide[after 12h] (P = 0.007) and the degree of lasting decrease in serum ΔC-peptide[after end of infusion] (P = 0.015). Conclusion: Exogenous insulin infusion suppressed the C-peptide concentration to individually different degrees. In addition, the effect of insulin infusion on β cells may be linked to individual insulin sensitivity, where a low insulin sensitivity resulted in a more pronounced decrease in C-peptide during insulin infusion.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Endocrinology and Metabolism
volume
104
issue
9
pages
9 pages
publisher
Oxford University Press
external identifiers
  • pmid:31058966
  • scopus:85084461616
ISSN
0021-972X
DOI
10.1210/jc.2018-02681
language
English
LU publication?
yes
id
c4631435-e577-49f0-bce8-6f1d488c960b
date added to LUP
2020-05-26 12:39:38
date last changed
2022-07-05 23:49:47
@article{c4631435-e577-49f0-bce8-6f1d488c960b,
  abstract     = {{<p>Context: Little is known about the individual response of glucose-regulating factors to administration of exogenous insulin infusion in extremely preterm infants. Objective: To evaluate longitudinal serum concentrations of insulin, C-peptide, and plasma glucose levels in a high-frequency sampling regimen in extremely preterm infants treated with insulin because of hyperglycemia. Design: Prospective longitudinal cohort study. Setting: Two university hospitals in Sweden between December 2015 and September 2016. Patients and Intervention: Serum samples were obtained from nine extremely preterm infants, gestational age between 22 (+3) and 26 (+5) weeks (+ days), with hyperglycemia (plasma-glucose &gt;10 mmol/L) at the start of insulin infusion, at 12, 24, and every 24 hours thereafter during ongoing infusion, and 12, 24, and 72 hours after the end of insulin infusion. Main outcome measures: Longitudinal serum concentrations of insulin and C-peptide and plasma glucose levels. Results: During insulin infusion, the serum C-peptide concentrations decreased compared with at start of infusion (P = 0.036), and then increased after ending the infusion. Individual insulin sensitivity based on the nonfasting plasma glucose/insulin ratio at the start of insulin infusion correlated with the initial decrease in serum ΔC-peptide<sub>[after 12h]</sub> (P = 0.007) and the degree of lasting decrease in serum ΔC-peptide<sub>[after end of infusion]</sub> (P = 0.015). Conclusion: Exogenous insulin infusion suppressed the C-peptide concentration to individually different degrees. In addition, the effect of insulin infusion on β cells may be linked to individual insulin sensitivity, where a low insulin sensitivity resulted in a more pronounced decrease in C-peptide during insulin infusion.</p>}},
  author       = {{Hellström, William and Hansen-Pupp, Ingrid and Hellgren, Gunnel and Engström, Eva and Stigson, Lennart and Sävman, Karin and Ley, David and Löfqvist, Chatarina}},
  issn         = {{0021-972X}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{3902--3910}},
  publisher    = {{Oxford University Press}},
  series       = {{Journal of Clinical Endocrinology and Metabolism}},
  title        = {{C-Peptide Suppression during Insulin Infusion in the Extremely Preterm Infant Is Associated with Insulin Sensitivity}},
  url          = {{http://dx.doi.org/10.1210/jc.2018-02681}},
  doi          = {{10.1210/jc.2018-02681}},
  volume       = {{104}},
  year         = {{2019}},
}