Increased pancreatic beta-cell secretory activity is usually associated with decreased alpha-cell activity; stimulated beta-cells release gamma-aminobutyric acid, which hyperpolarizes alpha-cells, inhibiting glucagon release.
Thus, insulin secretion and glucagon secretion are usually inversely coupled. This suggests that chromium and other insulin-sensitizing modalities, by down-regulating beta-cell activity, may increase glucagon secretion.
Such an effect might play a role in the documented therapeutic activity of supplemental chromium and biguanides in reactive hypoglycemia, and might also be of benefit to dieters.
McCarty MF: Chromium and other insulin sensitizers may enhance glucagon secretion: implications for hypoglycemia and weight control. Med Hypotheses, 1996 Feb, 46:2, 77-80.
Careful attention to nutrient delivery in the IUGR infant is important to prevent and treat neonatal metabolic derangements and to improve postnatal growth.
· Carbohydrates are the essential fuel in the first days of life, to prevent hypoglycemia.
· Subsequent delivery of protein and fat helps rectify reduced muscle and fat stores and promotes weight gain.
· Calcium supplementation to prevent further bone demineralization and
· Iron supplementation to replete iron stores may be necessary.
Of special interest is that the neurologic outcome of these infants appears linked to the rate of catch-up growth. The rate of postnatal head growth depends on many perinatal and neonatal risk factors, and is a strong predictor of early developmental outcome in low-birthweight infants. Insufficient energy delivery beyond 2 weeks postnatal age in SGA premature infants results in failure to initiate subsequent catch-up head growth, with consequently smaller head circumferences at 1-year follow-up.
Wahlig TM & Georgieff MK: The effects of illness on neonatal metabolism and nutritional management. Clin Perinatol, 1995 Mar, 22:1, 77-96.
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