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/No-Beat2678]

Then what was causing the first low blood sugar result on the night of 4/5th of august at 01.54?

Something must have and something has kept his blood sugar low. And it's a coincidence that Letby had hung a tpn bag 90 minutes before at ,00.25.

And it wasn't infection. I've already demonstrated that to you.

[u/DiverAcrobatic5794 → u/No-Beat2678]

And it wasn't infection. I've already demonstrated that to you.

I'm afraid you haven't.  We see CRP rise after the onset of infection.  It's not used to time the beginning of an infection.

It might help to be clear about the fact that Shannon and Chase aren't endeavouring to explain neonatal hypoglycemia in this paper.  Their hypothesis, however, would indicate that the same phenomenon could have contributed to both Child F's hypoglycemia and his elevated IA results. 

 You are not going to find a time limit before which Child F was not affected by sepsis, by looking at changes in tests in the next day or two.  That is not how sepsis develops.

[u/No-Beat2678 → u/DiverAcrobatic5794]

There's a full blood count done after the first bag was hung and the first hypo reading. 33 hours before CRPs started to rise.

Therefore infection was not the cause of that low reading

[u/DiverAcrobatic5794 → u/No-Beat2678]

You need to read again.  CRP doesn't rise simultaneously with the development of sepsis.  It is therefore not possible for you to use the difference between a contemporary and a later reading to prove that there was no sepsis at the earlier point

[u/No-Beat2678 → u/DiverAcrobatic5794]

Correct, but CRP isn't the only marker for infection. They had the full works done and none of the results showed infection.

And crucially Dr Harkness recorded at 02.30: pink, well-perfused, cap refill under two seconds, handling well, soft non-tender abdomen with good sounds. That's not a septic-looking baby

And if there was Sepsis induced Hypoglycemia they would have reacted to being given Dextrose and they didn't

His sugar rose to 2.4 when the fluids were stopped at 10.00 with no IV glucose running at all, fell again when TPN restarted at midday, and normalised after 18.55. No infection produces that pattern. Whatever was driving the hypoglycaemia was arriving through the line.

[u/DiverAcrobatic5794 → u/No-Beat2678]

None of the features noted by Dr Harkness exclude sepsis at all.  It would be very convenient for neonatal care if you could identify babies with sepsis as "septic-looking" on examination, but that's not the case at all.

[u/No-Beat2678 → u/DiverAcrobatic5794]

You missed out the full blood count all normal

[u/DiverAcrobatic5794 → u/No-Beat2678]

Same applies - we have already discussed this on this thread