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[Carbohydrate metabolism of infants with prenatal dystrophy and infants of diabetic mothers. Glucosetolerance and insulinsecretion in the first week of life (author's transl)].
Alterations of carbohydrate metabolism were studied in infants of insulin dependent diabetic mothers and in small for date babies with and without prenatal dystrophy. Glucose assimilation (Kt-value) and insulin secretion after i. v. glucose load were examinated on the 1st, 3rd, and 5th day of life. Infants of diabetic mothers showed the highest Kt-values, fasting insulin levels and insulin peaks of all patients examinated. Hyperinsulinism and Kt-values decreased from the 1st to the 3rd day and from the 3rd to the 5th day. In this group the infants of mothers with strictly controlled diabetes showed lower Kt-values, lower insulin peaks and less pronounced cushingoid facies. Small for date babies, on the other hand, had a reduced glucose tolerance on the first day, which normalised up to the 3rd day. The glucose tolerance in small for date babies with prenatal dystrophy, however, showed a tendency to deteriorate again from the 3rd to the 5th day with decreasing Kt-values as well as reduced insulin secretion, which was well documented in two cases. Deterioration of pancreas function and failing adaption to post partum nutrition is put forward as a tentative explanation.
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