Dear Jean:

Wow - I am really embarrassed now!    I am an IBCLC who is not an
RN and who has never worked in a medical field and although I do 
keep up, I've worked in private practice for 18 years and probably
see fewer 'medical' conditions than the typical RN - LC's who work
in hospitals.  Guess I'd better start digging in to learn more about this.
My brother was a Type 1 diabetic (he died in 1975 of kidney failure)
so I have a 'basic' understanding of that disease process, and a bit
about hypoglycemia as well, but apparently I still do not have a very 
good understanding of glucose metabolism.  I did wonder how this
baby was doing OK without insulin.  and...I thought diabetes was 
'never' found in infants.  

Do you (or any other LC's out there) have any resources for me to 
seek further information on this topic?  Jean I do appreciate your
patience with this lay-person.

Warmly
Sharon Mattes, IBCLC, RLC, AAHCC
Natural Beginnings...the informed parent's resource
(972) 495-2805 - www.naturalbeginningsonline.com


One person with a dream is equal to 99 who only have an interest!
  ----- Original Message ----- 
  From: Kermaline Cotterman 
  To: Cc: [log in to unmask] 
  Sent: Thursday, November 17, 2005 3:22 PM
  Subject: Hyperinsulinism


  No, Sharon. I still didn't get my point across. I'll try again.

  <And thanks to Jean Cotterman for reminding me about hyper and hypo for 
  this condition.  Should keep that straight.  Hyper means too much insulin and 
  this baby seems to not be producing any insulin (hypo)...>

  Generally, the problem is not so much with the baby's ability to produce insulin. 
  A baby who would not be producing any insulin would be a very sick baby indeed-
  profound diabetes in the newborn. I don't even know if such a condition exists, 
  because it would be so life-threatening as to endanger chances of survival even in 
  the uterus. While glucose crosses the placenta, insulin cannot, so the baby and the 
  mother each need to make their own. Perinatal mortality statistics have improved 
  as the understanding of glucose metabolism has improved. 


  Rather, the problem usually lies with the instability of the blood glucose supply and its
   feedback mechanism with the pancreas. (Like a furnace and a thermostat, reciprocating 
  turning on and off, depending on the heat (glucose) level that's triggering the re-balancing 
  activity (furnace on/off -- glucose supply/reserve.) This, of course could be exacerbated by 
    a.. under-feeding (not enough glucose substrate in the diet), or 
    b.. by temporary reactive hyper-secretion of fetal/newborn insulin due to maternal 
    hyperglycemia (too high a blood sugar in the mother, either from poorly 
    controlled diabetes, or too rapid infusion of IV glucose before birth) 
    c.. but much more likely due to inadequate stores of glycogen in the baby's 
    muscles and especially in the liver, in preparation for the transition from placental 
    to oral nutrition.
  Just wanted to be sure to keep the insights on LN fairly straight!

  Jean
  **********************
  K. Jean Cotterman RNC, IBCLC
  Dayton, OH USA

   

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