Maternity Nursing Q 184
The neonate of a mother with diabetes mellitus is prone to developing hypoglycemia because:
A. The pancreas is immature and unable to secrete the needed insulin.
B. There is rapid diminution of glucose level in the baby’s circulating blood and his pancreas is normally secreting insulin.
C. The baby is reacting to the insulin given to the mother.
D. His kidneys are immature leading to a high tolerance for glucose.
Correct Answer: B. There is rapid diminution of glucose level in the baby’s circulating blood and his pancreas is normally secreting insulin.
If the mother is diabetic, the fetus while in utero has a high supply of glucose. When the baby is born and is now separate from the mother, it no longer receives a high dose of glucose from the mother. In the first few hours after delivery, the neonate usually does not feed yet thus this can lead to hypoglycemia.
Option A: The primary function of ?-cells is to store and secrete insulin in response to glucose load. When ?-cells lose the ability to adequately sense blood glucose concentration, or to release sufficient insulin in response, this is classified as ?-cell dysfunction. ?-cell dysfunction is thought to be the result of prolonged, excessive insulin production in response to chronic fuel excess
Option C: ?-cell dysfunction is exacerbated by insulin resistance. Reduced insulin-stimulated glucose uptake further contributes to hyperglycemia, overburdening the ?-cells, which have to produce additional insulin in response. The direct contribution of glucose to ?-cell failure is described as glucotoxicity. Thus, once ?-cell dysfunction begins, a vicious cycle of hyperglycemia, insulin resistance, and further ?-cell dysfunction is set in motion.
Option D: Insulin resistance occurs when cells no longer adequately respond to insulin. At the molecular level, insulin resistance is usually a failure of insulin signaling, resulting in inadequate plasma membrane translocation of glucose transporter 4 (GLUT4)—the primary transporter that is responsible for bringing glucose into the cell to use as energy.