1457 GLYCEMIC EFFECT OF TRIGLYCERIDE INFUSION IN THE LOW BIRTH WEIGHT INFANT

Elevation of blood glucose is induced by triglyceride infusion in the newborn rat and in adult man either by stimulating gluconeogenesis or by decreasing glucose utilization. We evaluated the possibility of a glycemic response to triglyceride infusion in 9 infants with a birthweight of 1196±84 grams (M±SEM) and a gestational age of 30.0±0.5 weeks who were given a fat emulsion, 10% Intralipid (IL) at 6.5±0.7 days of age. All were clinically stable and were receiving glucose-amino acid infusions of 10.6±0.8 mg/kg/min of glucose and 1.7±0.2 g/kg/day of amino acids. A control period of one hour prior to IL infusion documented a steady-state of glucose (<±6% variation of plasma glucose). Subsequently IL was infused at the rate of 1 gm/kg over 2 hours in addition to the glucose-amino acid infusion continued at the same rate as control period. FFA availability produces a significant glycemic response despite a concomitant rise in plasma insulin suggesting either enhanced gluconeogenesis or diminished peripheral glucose uptake. Hyperglycemia should be considered a potential untoward effect of rapid fat emulsion infusion in the low birth weight infant.