Why do we have Hypocalcemia in Infants of Diabetic Mothers? - USMLE Forums
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Old 05-26-2012
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Pediatrics Why do we have Hypocalcemia in Infants of Diabetic Mothers?

Hey guys, I was wondering why of the hypocalcemia in the case of maternal diabetes, I've read is about hypophosphatemia but why the hypophosphatemia

IŽd really appreciate if anyone know the pathophysiology of the neonatal hypocalcemia
Thnx a lot in advance
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Old 05-26-2012
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neonatal hypocalcemia

Diabetes mellitus in the mother - Magnesium depletion in mothers with diabetes mellitus ( through renal loss because of glycosuria or ketoaciduria) causes a hypomagnesemic state in the fetus, which induces functional hypoparathyroidism and hypocalcemia in the infant; a high incidence of birth asphyxia and prematurity in infants of diabetic mothers is also a contributing factor

Magnesium is a cofactor in more than 300 enzyme-regulated reactions, most importantly forming and using ATP, i.e., kinase.[6] There is a direct effect on sodium (Na), potassium (K), and calcium (Ca) channels. It has several effects:
Potassium channels are inhibited (closed) by magnesium. Hypomagnesemia results in increased efflux of intracellular potassium in the distal nephron of the kidney (and out of the body in urinary losses). This condition is believed to occur secondary to the decreased normal physiologic magnesium inhibition of the ROMK channels in the apical tubular membrane.[8] In hypokalemic patients who do not respond to oral potassium supplementation, frequently, hypomagnesemia is the cause; if it is corrected, the oral potassium will then become effective. For example, patients with diabetic ketoacidosis (DKA) commonly being treated with insulin, a hormone which drives extracellular potassium intracellularly, must have their magnesium monitored and corrected so that supplemented potassium is not lost in the urine. That is, the magnesium binds to and shuts off the "potassium sink" losses.
Release of calcium from the sarcoplasmic reticulum is inhibited by magnesium. Low levels of magnesium stimulate the release of calcium and thereby an intracellular level of calcium. This effect similar to calcium inhibitors makes it "nature's calcium inhibitor." Lack of magnesium inhibits the release of parathyroid hormone, which can result in hypoparathyroidism and hypocalcemia. Furthermore, it makes skeletal and muscle receptors less sensitive to parathyroid hormone.

Last edited by Novobiocin; 05-26-2012 at 05:27 PM.
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Old 05-28-2012
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Default re to hypocalcmia

Excellent bro thnx a lot!
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Electrolytes-, Pediatrics-

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