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Endogenous glucose production from infancy to adulthood: a non-linear regression model
  1. Hidde H Huidekoper1,
  2. Mariëtte T Ackermans2,
  3. An F C Ruiter2,
  4. Hans P Sauerwein3,
  5. Frits A Wijburg1
  1. 1Department of Paediatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  2. 2Departement of Clinical Chemistry, Laboratory for Endocrinology and Radiochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  3. 3Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Dr Hidde Huidekoper, Department of Paediatrics (H7-225), Academic Medical Center, University Hospital of Amsterdam, PO Box 22660, Amsterdam NL-1100 DD, The Netherlands; h.h.huidekoper{at}amc.nl

Abstract

Objective To construct a regression model for endogenous glucose production (EGP) as a function of age, and compare this with glucose supplementation using commonly used dextrose-based saline solutions at fluid maintenance rate in children.

Design A model was constructed based on EGP data, as quantified by [6,6-2H2] glucose dilution after fasting overnight during normoglycaemia, in 40 healthy subjects aged 2.5–54.3 years old. The data were analysed using non-linear regression modelling with a 1-phase exponential decay curve fit. This model was compared to the amount of glucose provided with 2.5% or 5% dextrose-based saline solutions infused at fluid maintenance rate.

Results Non-linear regression analysis of the EGP data yielded the following regression model: EGP (mg/kg/min) = 6.50 × 2.72–0.145 × age (y)+1.93. Glucose supplementation at fluid maintenance rate with a 5% dextrose-based saline solution ranged from 46% at age 1 year to 55% at age 18 years of the glucose required to preclude the need for EGP. With a 2.5% dextrose-based solution, these percentages are 23% at age 1 year to 27% at age 18 years.

Conclusions we present an accurate non-linear regression model for EGP as a function of age. With standard dextrose-based saline solutions infused at fluid maintenance rate, only approximately 50% or less of EGP is provided. With prolonged infusion of these solutions, the deficit between exogenous glucose supplementation and EGP may induce a catabolic state and may ultimately lead to hypoglycaemia, especially in younger children.

  • Paediatric Practice
  • General Paediatrics
  • Metabolic

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