Journal List > Korean J Perinatol > v.27(2) > 1013802

Korean J Perinatol. 2016 Jun;27(2):95-102. Korean.
Published online June 30, 2016.  https://doi.org/10.14734/kjp.2016.27.2.95
Copyright © 2016 The Korean Society of Perinatology
Glucose Homeostasis during Fetal and Neonatal Period
Won Im Cho, M.D. and Hye Rim Chung, M.D., Ph.D.
Departemnet of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.

Correspondence to: Hye Rim Chung. Department of Pediatrics, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620 Korea. Tel: +82-31-787-7292, Fax: +82-31-787-4054, Email: chyerim@hanmail.net
Received June 19, 2016; Revised June 29, 2016; Accepted June 30, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.

Keywords: Glucose; Fetus; Neonate; Hypoglycemia

Figures


Fig. 1
Screening for and management of postnatal glucose homeostasis in late-preterm (gestational age 34 -36+6 weeks) and term small-for-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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Tables


Table 2
Neonates at Increased Risk for a Persistent Hypoglycemia Disorder
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