Lage insulinewaarden bij pasgeborenen rond de à terme datum

Background. Insulin resistance is an important factor in the pathogenesis of type 2 diabetes. In newborns, prematurity and low birth weight (small for gestational age, SGA) might be contributing factors in developing decreased insulin sensitivity. The aim of this pilot study was to measure glucose and insulin concentrations and to calculate HOMA to evaluate insulin sensitivity in infants of different gestational age and birth weight categories. Sample time was set at term-equivalent age to compare groups at a similar maturation level. Methods. Cross-sectional observational pilot study. Newborns between 25 and 42 weeks gestational age without serious co-morbidity on enteral nutrition ≥ 120 ml/kg/day at term-equivalent age were eligible. Blood samples for glucose and insulin were taken 3 hours after the last feeding. Results. In 35 of the 73 infants (48%) the insulin concentration was below the detection limit of the assay. There were no statistically significant differences in the patient characteristics of infants with a detectable versus an undetectable insulin concentration, but the glucose concentration was higher in infants with an insulin concentration above the detection limit. Conclusions. We found no differences between gestational age or weight groups in any of the parameters we used to assess insulin sensitivity at term-equivalent age. Insulin concentration was below the detection limit in almost half of the newborns in our study, suggesting excellent insulin sensitivity at term-equivalent age. However, this makes HOMA an unsuitable tool to study insulin sensitivity in this age group.