METABOLIC OBSERVATIONS IN INFANTS OF STRICTLY CONTROLLED DIABETIC MOTHERS Plasma Levels of Glucose, FFA, Glycerol and D-β-hydroxybutyrate during the First Two Hours after Brith

Arterial concentrations of FFA, glycerol, glucose and D-β-hydroxybutyrate were serially measured during the first 2 hours after birth in IDMs, IGDMs and in control infants. All diabetic mothers were subjected to a well defined program of control during pregnancy. IDMs had only a slight increase in mean plasma FFA concentrations and the values were significantly lower than those of the IGDM and control groups at all times. In contrast the rise in mean plasma glycerol values was significant and similar in all groups, suggesting a comparable increase in lipolysis. Following birth IDMs showed a more pronounced decrease in mean plasma glucose values than the other groups. Mean plasma values of D-β-hydroxybutyrate showed a significant drop during the first 60 minutes and thereafter the values remained low and were not significantly different between the groups. The pattern of changes in FFA, glycerol and glucose was not influenced by type of delivery, duration of diabetes and/or presence of retinopathy in the mothers, nor was there any apparent relationship to the degree of maternal metabolic control during pregEancy. It is suggested that the low mean FFA levels despite of increasing mean glycerol concentrations in IDMs are explained by an increased rate of re-esterification of FFA withi!i adipose tissue. Thcse findings can only partly be explained by postnatal functional hyper-insulinism. The recent demonstration af higher than normal glycogen concentrations within adipose tissue in IDMs cffers a more plausible explanation for the increased rate of re-esterification during the first hours after birth. The p;esent data do not allow of conclusions as to thc relative importance of increased glycogen stores as compared with that of hyperinsulin-ism during the first 2 hours after birth in IDMs.