Abstract
Serum glucose and insulin concentrations were measured in 15 children older than 2 years of age for 30 minutes after abrupt discontinuation of total parenteral nutrition (TPN). The children ranged in age from 2.4 to 14.2 years (mean 7.9 years). These infants were receiving <10% of their caloric intake by the enteral route. Four patients were receiving corticosteroids. The glucose concentration in the TPN solutions at the time of discontinuation was 15% to 20%. The glucose infusion rate was 0.53 ± 0.23 mmol/kg/min (range 0.22 to 1.2) (9.6 ± 4.2 mg/kg/min; range 4 to 21). Paired glucose and insulin concentrations were measured before, 15, and 30 minutes after the TPN was abruptly discontinued. One child was considered an outlier because of insulin concentrations that were approximately 10-fold higher than the other children and was not included in the analysis. The initial insulin levels were elevated and rapidly became normal. Glucose concentrations were slightly elevated at the time parenteral nutrition was stopped but were normal and remained stable after 15 minutes. Only one child had a glucose concentration decrease to <3.3 mmol/L (60 mg/dL), and no child had symptomatic hypoglycemia. The investigators found no influence of glucose infusion rate, age, or use of corticosteroid on glucose or insulin concentrations.
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