A term neonate born to a non-diabetic mother develops jitteriness at 2 hours of life. Blood glucose is 35 mg/dL. Which physiological factor contributes MOST to the risk of neonatal hypoglycemia?

• A Impaired glucagon response due to immature liver
• B Excessive insulin secretion from fetal hyperglycemia
• C Inadequate glycogen stores and high brain-to-body weight ratio ✓
• D Increased glucose utilization by brown adipose tissue

Explanation

Neonates have limited hepatic glycogen stores (depleted within hours) and a disproportionately large brain-to-body weight ratio, making them glucose-dependent. Excessive insulin secretion occurs in infants of diabetic mothers, not this scenario. Glucagon response is present but immature. Brown fat uses fatty acids, not glucose, as its primary fuel for thermogenesis.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.