Comparing the glucose kinetics of adolescent girls and adult women during pregnancy

Background: Fetal energy demands are met mostly from oxidation of maternally supplied glucose. In pregnant adults this increased glucose requirement is met by an increase in gluconeogenesis. It is not known, however, whether, like their adult counterparts, pregnant adolescent girls can increase gluconeogenesis--hence, glucose production. Objective: Our objective was to measure glucose kinetics in 8 pregnant adolescents and 8 adult women. Design: We measured glucose kinetics after an overnight fast by using a primed-constant 6-h U-[sup.13]C-glucose infusion at the end of trimester 1 and early trimester 3. Results: From trimester l to trimester 3, whole-body glucose production increased significantly in both groups (P < 0.01). However, whereas the weight-specific rate in adults increased by 18.2%, it increased by only 14.3% in adolescents. In adults, the increase in whole-body glucose production was largely due to a significant increase (P < 0.01) in the rate of gluconeogenesis, but in adolescents there was no change in whole-body gluconeogenesis, and weight-specific gluconeogenesis actually decreased by 11.7%. In both groups, the rate of whole-body glycogenolysis increased significantly (P < 0.05) in trimester 3, and in adolescents, it increased by 95%. Conclusions: These findings suggest that, in the fasted state in late pregnancy, pregnant adolescents cannot increase weight-specific glucose production by the same magnitude as their adult counterparts. Furthermore, whereas adult women increase glucose production primarily through gluconeogenesis, adolescents do so through glycogenolysis. Am J Clin Nutr 2010;91:604-9. doi: 10.3945/ajcn.2009.28635.