Glucose extremes in newborn infants

Most healthy term infants adapt rapidly to the metabolic demands of extrauterine life by activating their glycogenolytic and gluconeogenic pathways within a few hours after birth. Some infants, although born at term, have disturbed glucose metabolism and are at risk of hypoglycemia [eg, infants with transient hyperinsulinemia, growth retarded infants (SGA), infants with persistent hyperinsulinemia (PHHI) and with hormone and enzyme defects]. Premature infants also activate their metabolic pathways shortly after birth, but limited storage of body fuel places them at high risk of hypoglycemia. Because these infants have decreased tolerance for enteral feedings, they are dependent on parenteral nutrition during the first weeks of life. They have, however, a low tolerance for parenteral glucose, resulting in a frequent occurrence of hyperglycemia.