Selected principles of perinatal–neonatal glucose metabolism

Cowett, Richard M.; Farrag, H.

doi:10.1016/s1084-2756(03)00113-1

Cited by 69 publications

(67 citation statements)

References 41 publications

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“…The known mechanisms responsible for hyperglycaemia specific to extremely premature infants are related to their reduced ability to produce insulin [11]; defective beta-cell processing of pro-insulin (which is 10-16 times less active than insulin) to insulin [12]; an inability to suppress hepatic glucose production in response to glucose infusion [13]; and, finally, a decreased uptake of glucose secondary to a limited mass of insulin-sensitivity tissues (e.g. : muscle and adipose tissue) [14].…”

Section: Introductionmentioning

confidence: 99%

“…The upper limit for clinically desirable blood glucose concentration is also subject to debate [11]. Thus, glucose management goals vary widely between insulin therapy studies [30,35] and it is likely the desired target range for glucose may change in the future.…”

Section: Introductionmentioning

confidence: 99%

“…It is well known that neonatal response to insulin and glucose infusions exhibits great heterogeneity [11,24], which would render fixed protocols ineffective because they do not adopt well to different patients or the evolution of metabolic response over time within an individual patient. Model-based blood glucose control may provide more optimized care by adapting in real-time to identified parameters representing the current metabolic state of the infant, and using this information to drive insulin dosing.…”

Section: Introductionmentioning

confidence: 99%

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Development of blood glucose control for extremely premature infants

Compte

Chase

Lynn

et al. 2011

Computer Methods and Programs in Biomedicine

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Abstract:Extremely premature neonates often experience hyperglycaemia, which has been linked to increased mortality and worsened outcomes. Insulin therapy can assist in controlling blood glucose levels and promoting needed growth. This study presents the development of a model-based stochastic targeted controller designed to adapt insulin infusion rates to match the unique and changing metabolic state and control parameters of the neonate. Long-term usage of targeted BG control requires successfully forecasting variations in neonatal metabolic state, accounting for differences in clinical practices between units, and demonstrating robustness to errors that can occur in everyday clinical usage. Simulation studies were used to evaluate controller ability to target several common BG ranges and evaluate controller sensitivity to missed BG measurements and delays in control interventions on a virtual patient cohort of 25 infants developed from retrospective data. Initial clinical pilot trials indicated model performance matched expected performance from simulations. Stochastic targeted glucose control developed using validated patient-specific virtual trials can yield effective protocols for this cohort. Long-term trials show fundamental success, however clinical interface design appears as a critical factor to ensuring good compliance and thus good control.3

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development of blood glucose control for extremely premature infants

Compte

Chase

Lynn

et al. 2011

Computer Methods and Programs in Biomedicine

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“…Hewlett and Winn's review should stimulate exploration of developmental experience and allonursing, including perinatal and postnatal metabolic and neurophysiological risks (Cowett and Farrag 2004;Dunsworth et al 2012;Neubauer and Hublin 2012).…”

Section: Is Efé Allonursing a Developmental Strategy?mentioning

confidence: 99%

Allomaternal Nursing in Humans

Hewlett

Winn²

2014

Current Anthropology

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Few studies exist of allomaternal nursing in humans. It is relatively common among some cultures, such as the Aka and Efé hunter-gatherers of the Congo Basin, but it does not occur in other foragers such as the !Kung and Hadza of Southern and East Africa. This paper utilizes focal follow observations of Aka and Efé infants, interviews with Aka mothers, ethnographic reports from researchers working with hunter-gatherers, and a survey of the eHRAF cultures to try to answer the following questions: how often does allomaternal nursing occur, who provides it, and under what contexts does it take place? The study indicates that it occurs in many cultures (93% of cultures with data) but that it is normative in relatively few cultures; biological kin, especially grandmothers, frequently provide allomaternal nursing and that infant age, mother's condition, and culture (e.g., cultural models about if and when women other than the mother can nurse an infant or colostrum taboos) impact the nature and frequency of allomaternal nursing. The empirical results of this exploratory study are discussed in the context of existing hypotheses used to explain allomaternal nursing.Anthropologists have conducted several studies of breastfeeding from a variety of perspectives (Fouts, Hewlett, and Lamb 2012;Gottlieb 2004;Sellen 2007) and have occasionally described allomaternal nursing, that is, women other than mother nursing infants, but quantitative studies on the topic do not exist. Nutritional and health benefits of breast-feeding for mothers and infants are well documented (see American Academy of Pediatrics [2005] and Field [2005] for reviews), but what about infants who are breast-fed by women other than mother? Lactation is energetically costly, and allomaternal nursing may increase pathogen transmission between mothers and other infants. La Leche League, a global organization that promotes and assists women with breast-feeding, discourages both wet nursing (nursing another woman's infant, often for pay) and cross-nursing (the occasional nursing of another woman's infant while the mother continues to nurse her own child, often in a child-care situation), because the other women may transmit infectious diseases to the infant or cause the infant to be psychologically confused (Lawrence and Lawrence 2011;Minami 1995). Exceptions exist if the mother has health or other issues that lead to breast-feeding difficulties. 1 Allomaternal nursing occurs in many cultures. Our review of cultures in the electronic Human Relations Area Files (eHRAF), a digital database of 258 cultures from around the world, found that it existed in 97 of 104 cultures with ethnographic data about Barry S. Hewlett is a Professor in the Department of Anthropology of Washington State University, Vancouver (Vancouver, Washington 98686, U.S.A. [hewlett@vancouver.wsu.edu]). Steve Winn is Senior Vice President at the Behavioral Health Network (417 Liberty Street, Springfield, Massachusetts 01104, U.S.A.). This paper was submitted 8 VI 11, accepted 18 I 13, and ele...

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“…This rate is relatively constant [19], irrespective of the body's plasma insulin concentrations [20]. CNS uptake is a required parameter in the NICING model, as [13] notes that in contrast to the adult case, the brain represents a major source of glucose uptake in infants, due to their larger brain-to-body weight ratio.…”

Section: Introductionmentioning

confidence: 99%