Insulin sensitivy, insuline sensitiviteit Prematurity, prematuriteit Small for gestational age, dysmaturiteit
Conditions
Interventions
Not applicable. Observational study
Sponsors
Drs I.A. Zonnenberg
Academisch Medisch Centrum
Neonatologie, H3-213
Meibergdreef 9
1105 AZ Amsterdam
Eligibility
Inclusion criteria
Inclusion criteria: 1. Premature infants 28-32 weeks gestational age; 2. Presence of a (central) venous and arterial catheter for clinical reasons; 3. For preterm SGA infants: growth retardation caused by placental insufficiency, assessed by maternal history (pregnancy induced hypertension, preeclampsia), and confirmed by Doppler flow measurements of the umbilical arteries (Pulsatility index, PI, >+2 SD for gestational age, measured on two occasions)
Exclusion criteria
Exclusion criteria: 1. For preterm SGA infants: growth retardation based on other causes (e.g. congenital infections, congenital malformations); 2. Major congenital malformations; 3. Severe perinatal asphyxia defined as 5 minute Apgar score 8 mg.kg-1.min-1, or need for insulin therapy to maintain the glucose concentration between 2.6 and 8 mmol/l); 5. Severe respiratory distress. Mild ventilatory support is allowed: a. nCPAP with maximum FiO2 of 0.40, maximum PEEP 6 cm H2O; b. SIMV with maximum inspiratory peak pressure of 18 cm H2O and maximum FiO2 of 0.40; c. HFOV with maximum continuous distending pressure of 12 cm H2O and maximum FiO2 of 0.30; 6. Need of vasopressor support for hypotension; 7. Treatment with systemic corticosteroids; 8. Clinical or laboratory evidence of sepsis: lethargy or irritability, hypo- or hyperthermia, temperature instability, tachypnea, apnea, bradycardia, hypotension, gastric retention, abdominal distension, pallor, elevated CRP-level, leukocytosis or leukocytopenia and increased number of band neutrophils; 9. Low haemoglobin level at the study days with need for a blood transfusion; 10. Positive family history for type 2 diabetes in first degree relatives; 11. No informed consent from parents or legal guardians.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Rate of appearance and disappearance of glucose during insulin infusion | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Rate of gluconeogenesis and glycogenolysis; 2. Plasma FFA concentrations; 3. Plasma concentrations of insulin, cortisol and adiponectin. | — |
Contacts
Public ContactH.P. Sauerwein
Academic Medical Center (AMC), Department of Endocrinology and Metabolism, F5-170, P.O. Box 22660
Outcome results
None listed