| Popis: |
The growing fetus has a high energy requirement to satisfy the needs of metabolism and growth, 80% of which is met by glucose. In healthy pregnancies, the majority of this glucose requirement is maintained by a continuous and well-regulated placental transfer from mother to fetus. After delivery and clamping of the umbilical cord, there is a transitional period of catabolism before the primary energy source becomes milk, which is high in fat but low in carbohydrate. During this transition period, it is vital that there is upregulation of the enzymes involved in gluconeogenesis and that insulin secretion and incretins are linked to the intermittent enteral delivery of milk to ensure homeostasis during fasting and feeding. During this critical period of physiological adaptation, infants are at risk of both hyperglycemia and hypoglycemia, if the appropriate regulation of these processes, and the availability of the necessary substrates for glucose metabolism are not available. |
