In a newborn whose mother has type 1 diabetes, which fetal condition most likely causes postnatal hypoglycemia?

In the context of a newborn whose mother has type 1 diabetes, postnatal hypoglycemia is primarily caused by the infant's increased insulin production in response to elevated levels of glucose in the maternal circulation. When the fetus is exposed to high maternal blood glucose levels, the fetal pancreas compensates by producing more insulin. After birth, when the umbilical cord is clamped, the supply of maternal glucose is abruptly terminated. However, the infant's insulin levels may remain high, leading to a situation where the newborn's body continues to utilize glucose at a rate that exceeds supply, resulting in hypoglycemia.

Decreased gluconeogenesis refers to a reduction in the production of glucose from non-carbohydrate substrates, which would normally help to maintain blood sugar levels during periods of fasting or low blood sugar. In a newborn that is adapting to life outside the womb, an inability to produce adequate glucose can contribute to hypoglycemia; however, in this scenario, the immediate concern is not solely about gluconeogenesis, but rather about the infant’s overall ability to manage glucose levels post-delivery in the context of continued insulin secretion following exposure to high glucose levels in utero.

This understanding highlights the relationship between maternal diabetes and newborn metabolic responses, particularly