Korean J Perinatol.  2016 Jun;27(2):95-102. 10.14734/kjp.2016.27.2.95.

Glucose Homeostasis during Fetal and Neonatal Period

Affiliations
  • 1Departemnet of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea. chyerim@hanmail.net

Abstract

Glucose is essential for energy metabolism in human, especially in brain, and is a source of energy storage in the form of glycogen, fat and protein. During fetal life, the predominant source of energy is also glucose, which crosses the placenta by facilitated diffusion. There is very little endogenous glucose production under normal circumstances during fetal life. During labor, the fetus is exposed to physiological challenges that require metabolic adaptation. A healthy infant successfully manages the postnatal transition by mobilizing and using alternative. After birth, there is a rapid surge in catecholamine and glucagon levels, and a steady decrease in insulin, as blood glucose levels decline. These hormonal changes induce enzyme activities that lead to glycogenolysis and gluconeogenesis. During the first 24-48 hours of life, plasma glucose concentrations of neonates are typically lower than later in life. Distinguishing between transitional neonatal glucose regulation in normal neonates and hypoglycemia that persists or occurs for the first time beyond the first 72 hours of life is important for prompt diagnosis and treatment to avoid serious consequences.

Keyword

Glucose; Fetus; Neonate; Hypoglycemia

MeSH Terms

Blood Glucose
Brain
Diagnosis
Energy Metabolism
Facilitated Diffusion
Fetus
Glucagon
Gluconeogenesis
Glucose*
Glycogen
Glycogenolysis
Homeostasis*
Humans
Hypoglycemia
Infant
Infant, Newborn
Insulin
Parturition
Placenta
Blood Glucose
Glucagon
Glucose
Glycogen
Insulin

Figure

  • Fig. 1 Screening for and management of postnatal glucose homeostasis in late-preterm (gestational age 34 –36+6 weeks) and term smallfor-gestational age infants and infants who were born to mothers with diabetes, large-for-gestational age infants. Modified from Pediatrics 2011;127:575-9.8


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