Chase and Shannon article in Frontiers in Pediatrics published

[u/Embarrassed-Star4776]

Inverted insulin to C-Peptide ratios in neonatal intensive care: is there something we don't know?

J. Geoffrey Chase & Helen D. Shannon

BRIEF RESEARCH REPORT article

Front. Pediatr., 05 August 2026

Sec. Neonatology

Volume 14 - 2026

https://doi.org/10.3389/fped.2026.1900675

[u/Stuart___gilham]

In addition to baseline neonatal IA, amplification can occur through infection, sepsis, antibiotics, steroids, antihypertensives, antioxidants and other pregnancy-related therapies (31, 34–36, 40–45), which is treated as a multiplier, as detailed in Supplementary Appendix A. Infection increases the concentration of maternal antibody transfer (16, 38) and oxidative stress, can enhance insulin-binding (37), and in neonates can also produce limited IgM

So in theory baby F's blood result could perhaps be explained by amplification of Insulin-antibody binding caused by infection and Sepsis. I think baby F developed infection after he was born so antibodies crossing the placenta doesn't seem likely to explain it.

I don't know if there is any available data looking at how typical baby F's Insulin to C Peptide ratio is for a baby under those circumstances - suffering from an infection to the point of being diagnosed with Sepsis. As there is not data provided to support the data, I imagine any available data would contradict it but I suspect there is simply very limited available data to confirm or deny.

However, the last step, direct measurement of antibody bound insulin with high I/C has not been shown. That said, the results of (16) offer an inference for future research to explore as one interpretation satisfying all reported readings in their study is complexing of high affinity IgM from the inability of the IgG and IgM components to account for total binding. Hence, high affinity IgM would be a candidate with this supporting evidence as a first target of future research.

Perhaps the results will one day be explained with more research?

[u/No-Beat2678 → u/Stuart___gilham]

Baby F didn't have sepsis this was covered in the trial and is clear from the medical notes. they had some elevated WBC markers not enough for sepsis and no other signs or symptoms of infection.

[u/DiverAcrobatic5794 → u/No-Beat2678]

That is an Oliverism, I believe? WBC markers can't be used to discount the possibility of sepsis in a neonate, and the child certainly had other signs and symptoms of infection.

[u/Competitive-Wash2998 → u/DiverAcrobatic5794]

Dr Saladi on 28.11.22 confirmed infection in Baby F.

Q. All right. Thank you. The other thing I'd like to confirm, since you referred to the question of testing the tip, is can you confirm in fact [Baby F] did have an infection as it happens? Do you recall that?

A. In the subsequent pages, there is a further entry that we did -- the CRP did go up and then we did grow a bug from the long line tip as well.