Measurement of “True” Glucose Production Rates in Infancy and Childhood with 6,6-Dideuteroglucose

TLDR

The study measured new glucose production in 54 infants and children by continuous 3–4 h infusion of the nonradioactive tracer 6,6‑dideuteroglucose and quantified deuterium enrichment in microliter blood samples using GC‑MS with <2 % error. Glucose production rose with body weight, reaching near adult levels (≈173 mg/min) and, when normalized per kilogram, ranged from 5.46 mg/kg/min in preterms to 7.1 mg/kg/min in children under six, indicating brain size may largely determine hepatic glucose output across life. Data are relative to an 80‑kg adult reference.

Abstract

"New" glucose production has been measured in 54 infants and children for the first time by continuous three-to-four-hour influsion of the safe, nonradioactive tracer 6,6-dideuteroglucose. The use of combined gas chromatography--mass spectrometry with monitoring of selected ions allowed deuterium enrichment in blood glucose to be measured on microliter samples with an error of less than 2 per cent. In the young child, glucose production increased in a slightly curvilinear manner from 1 kg. to 25 kg. body weight, when it reached 140 mg. per minute, almost the adult value of 173 mg. per minute (2.28 +/- 0.23 mg./kg.-min., mean +/- S.E.). Normalized for weight, glucose production in premature infants was 5.46 +/- 0.31 mg./kg.-min., in term neonates averaged 6.07 +/- 0.27 mg./kg.-min., in children below the age of six years was 7.1 +/- 0.27 mg./kg.-min., and in late childhood averaged 5.4 +/- 0.28 mg./kg.-min. To the age of six years was 7.1 +/- 0.27 mg./kg.-min. Rel ative to the 80-kg. adult. These data, the first measurements of "new" glucose production in childhood, suggest that brain size may be a principal determinant of those factors that regulate hepatic glucose output throughout life.