Carbohydrate and lipid abnormalities in infants of diabetic mothers.

Abnormalities of carbohydrate and lipid metabolism in infants of diabetic mothers are accounted for by maternal hyperglycemia shortly before and during delivery, and are caused by excessive fetal insulin secretion at birth. Thus, hypoglycemia and suppressed lipolysis (low serum free fatty acid and blood ketone body concentrations) in the newborn infant are correlated with cord serum C-peptide and free insulin levels at birth. Hypoglycemia is usually self-correcting, and treatment is required only in symptomatic or prolonged (over 6 hr) cases' Postheparin plasma lipoprotein lipase activity is twice as high in infants of diabetic mothers as in infants of normal mothers; this enzyme is inducible by insulin. For optimal homeostasis of the fetus and newborn infant, careful control of maternal blood glucose is necessary, not only during pregnancy but also during delivery.