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The Metabolic Sequelae in the Infant of the Diabetic Mother

  • Chapter
Controversies in Diabetes and Pregnancy

Part of the book series: Endocrinology and Metabolism ((EAM,volume 2))

Abstract

From a developmental standpoint, the normal newborn is in a transitional state relative to glucose homeostasis. The delivery of glucose to the fetus depends on the mother, whose glucose homeostasis as an adult is regulated to a fine degree (1). In contrast, maintenance of glucose homeostasis may be a major problem even in the normal newborn (2). This is because the newborn must provide for energy (particularly for the brain, which consumes 70% of glucose production per kilogram per minute) and growth while maintaining a balance between continuous glucose needs and intermittent oral intake. Thus, homeostasis depends on a balance between substrate availability and developing hormone (insulin and contra-insulin hormones), neural, and enzymatic systems. The precarious nature of this balance is emphasized by the frequent occurrence of neonatal hypoglycemia or hyperglycemia and associated morbidities, especially in the infant of the diabetic mother (IDM). Although study of the IDM has provided much information about the pathophysiology of glucose homeostasis, the discussion that follows shows how much additional work needs to be done. The problem has been discussed in a number of extensive reviews (3,4).

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  1. Richard M. Cowett
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  1. Sansum Medical Research Foundation, 93105, Santa Barbara, CA, USA

    Lois Jovanovic M.D.

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Cowett, R.M. (1988). The Metabolic Sequelae in the Infant of the Diabetic Mother. In: Jovanovic, L. (eds) Controversies in Diabetes and Pregnancy. Endocrinology and Metabolism, vol 2. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3792-1_10

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  • DOI: https://doi.org/10.1007/978-1-4612-3792-1_10

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