Abstract
Although children with congenital heart diseases have been found to have impaired carbohydrate metabolism. Insulin release response of children with congenital heart diseases has not been considered in relation to such factors as age, hypoxemia, and the states of the patients before and after cardiac surgery.
In order to clarify these points, the determination of plasma glucose (BS), immunoreactive insulin (IRI), JIRI/MBS (30 minutes value) after oral glucose tolerance tests were carried out in 83 patients with congenital heart diseases (3 years<; 55 patients, 4 years>; 28 patients) including 13 patients who had received cardiac surgery.
Suppression of insulin release was revealed in children of less than 3 years of age with and without cyanosis, especially in those with congestive heart failure or increased pulmonary flow. In the cyanotic group, the lower the oxygen saturation level the more depressed was the insulin release. Insulin release after cardiac surgery increased to the normal levels. However, patients with severe congenital heart diseases, and/or incomplete cardiac repair exhibited a lesser improvement in insulin release response.
These finding led us to the following conclusions:
Small age, increased pulmonaly flow, congestive heart failure, and cyanosis may be important factors contributing to the suppression of insulin release.
Hypoxemia may suppress the function of B-cell in the pancreas. There may be the clearance of insulin by the lung. The children with severe congenital heart diseases and/or incomplete repair after cardiac surgery may continue to have poorly functioning B-cell in the pancreas.
