A 2-Hour-Old Newborn Has a Blood Glucose Concentration of 30

A 2-hour-old newborn has a blood glucose concentration of 30 mg/dL.  The patient was delivered via caesarean to a 32-year-old woman at 38 weeks gestation.  Birth weight is 4.5 kg (9 lb 14 oz) .  The pregnancy was complicated by gestational diabetes treated with insulin.  However, glycemic control remained suboptimal due to maternal noncompliance with insulin treatment and poor adherence to dietary recommendations.  Examination of the neonate is unremarkable.  Which of the following is the most likely primary mechanism responsible for this patient's low blood glucose concentration?

A) Decreased glycogen stores
B) Hyperfunctioning pancreas
C) Impaired hepatic glycogenolysis
D) Increased release of cortisol
E) Insulin resistance

Correct Answer:

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