Intravenous Lipid and Amino Acids Briskly Increase Plasma Glucose Concentrations in Small Premature Infants

Abstract

We determined the glycemic response to intravenous lipid infusion alone, lipid with amino acids, or amino acids alone in 15 very small premature infants receiving constant glucose infusion during early life. Infants who received lipid or lipid and amino acids demonstrated significant increases in glucose compared with infants who received amino acids. The combination of lipid and amino acids resulted in an earlier increase than lipid alone. Although plasma insulin did not change in all three groups, infants who received amino acids alone demonstrated an appropriate increase in glucagon. These data suggest that lipid infusion, a commonly used means of providing nutrition to premature infants, may cause significant disturbances in glucoregulation, particularly when administered with amino acids.

Does continuous insulin infusion improve glycaemic control and nutrition in hyperglycaemic very low birth weight infants?

“…25 An additive effect has been noted when glucose and amino acids were added to the intravenous fat emulsion. 26 In contrast the establishment of oral feeds and the coupling of food related nutrient and hormonal signals increase the release of insulin. [27][28][29] However, in the VLBW infants it may not be possible to initiate oral feeding and thus induce normal insulin secretion.…”

Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology

“…Lipid infusions may have a beneficial effect, by reducing the glucose load whilst maintaining energy intakes, they can reduce the prevalence of hyperglycaemia ( 84 ). However, in excess or in acute illness, lipids have been reported to contribute to hyperglycaemia ( 85 ).…”