Neonatal Nurse Practitioner Practice Exam

Why are infants of diabetic mothers at increased risk for hypoglycemia?

1. Abnormalities in glucose metabolism

2. Altered regulation of insulin secretion

3. Inhibition of gluconeogenesis

4. Defects in insulin action

The correct answer is: Inhibition of gluconeogenesis

Infants of diabetic mothers are at increased risk for hypoglycemia primarily due to altered regulation of insulin secretion in response to the high glucose environment they experience in utero. When a mother has diabetes, especially if it is not well-controlled, her blood glucose levels can be elevated. This excess glucose crosses the placenta, leading to stimulation of the fetal pancreas, which then compensates by producing more insulin. After birth, the supply of maternal glucose is abruptly stopped, but the infant's insulin levels may remain elevated due to the hyperstimulation prior to delivery. This can lead to a situation where the infant's insulin is high, but the glucose supply is low, resulting in hypoglycemia. Therefore, altered regulation of insulin secretion is a critical factor in understanding why these infants are at risk for hypoglycemia. The other options presented do not fully address the primary mechanism leading to hypoglycemia in these infants. While abnormalities in glucose metabolism and defects in insulin action can have roles in glucose regulation, they are not the primary reasons for the hypoglycemic risk in this particular scenario. The inhibition of gluconeogenesis is also not the direct cause of hypoglycemia in this context, as it primarily affects the liver's ability to produce glucose rather than the