The effect of neonatal total parenteral nutrition on glucose metabolism in neonates and adult Yucatan miniature pigs

Total parenteral nutrition (TPN) is used when oral nutrition is not possible, but may cause metabolic disturbances, increasing the risk of Type 2 diabetes mellitus (T2DM). We hypothesize that TPN feeding early in life can alter glucose metabolism in a way that persists into adulthood, leading to the development of biomarkers associated with T2D. Additionally, we hypothesized that supplementing TPN with betaine and creatine could potentially correct these changes, and that intrauterine growth-restriction (IUGR) could exacerbate TPN-induced changes. We assigned 32 female Yucatan miniature piglets to four groups: normal birth weight receiving TPN (TPN); sow-fed (SF); normal birthweight TPN supplemented with betaine and creatine (TPN-B+C); and IUGR piglets fed TPN (TPN�IUGR). After 2 weeks on TPN (or SF), glucose metabolism and insulin sensitivity was assessed. All pigs were then fed an oral diet for ~10 mo, and glucose metabolism tests were repeated. TPN feeding showed significantly more sensitive glucose metabolism, which were more pronounced immediately after TPN but remained significant 10 mo later. TPN also increased insulin sensitivity, which was corrected by adding betaine and creatine. IUGR did not exacerbate TPN effects. This study suggests that TPN in early life can permanently impact glucose metabolism into adulthood, but these changes do not align with T2DM.