KV 2024

Data Handling task 3 (med SCi)

Two babies (A and B) are delivered by elective Caesarean section on account of their high birth
weight. Both babies (A and B) weigh over 6kg at birth. High birth weight can be associated with
diabetic complications even though neither of the mothers have any diabetic symptoms.

Baby C, weighing 5.6 kg is delivered normally at the same time as babies A and B. The parents of
baby C have no family history of diabetes. No family history is available for the other two babies
(A and B). After birth, blood glucose levels are determined every 4 hours.

Time (hours) Blood Glucose (mM)

Baby A Baby B Baby C
4 4.0 5.3 4.8
8 3.6 5.8 5.2
12 3.2 6.8 5.3
16 3.0 7.6 5.0
20 3.0 8.5 5.6
24 2.8 9.5 5.2
28 2.7 11.0
32 2.6 12.0
36 2.4 14.0
Table 1

(1) Comment on the data in the table above.

(2) What would be your initial diagnosis for babies A, B and C?

(3) Can you suggest any immediate course of treatment?

A number of clinical tests are performed using blood samples taken from babies A, B and C before
any treatment is initiated. An ELISA test for insulin was done.

(4) Draw a simple diagram to illustrate how ELISA works. What are the major advantages of the
technique.

Table 2 shows the results of the standard curve of an ELISA for insulin

[Insulin] Absorbance
picomole per
litre (pM)
0 0.03
3 0.05
10 0.012
30 0.24
100 0.43
300 0.70
1000 1.10
Table 2
(5) Draw a standard curve to determine insulin concentrations

Table 3 shows the results of the assays performed on blood samples that were taken from Baby A,
Baby B and Baby C before feeding and 30 minutes later.
 KV 2024
Data Handling task 3 (med SCi)

Absorbance
Before feeding After feeding
Baby A 0.80 0.84
Baby B 0.05 0.05
Baby C 0.22 0.58
Table 3
(6) Determine the concentration of insulin in the serum of each baby before and after
feeding. You may want to create separate table.

(7) Why is the test before and after feeding. Do the results support your initial diagnosis?

You find the results for baby A quite surprising and after doing some research you find
that pancreatic beta cells can have defects in the genes encoding for the following
proteins.
(i) SUR1 ( a component of the K+ channe in the plasma membrane
(ii) Glucokinase
(8) Explain how mutations in genes encoding these proteins can affect insulin secretion.
By taking Islet biopsies from baby A and baby C, the effect of varying concentrations of
glucose on the ATP content is investigated.
Results are shown in table 5.

Glucose ATP (mM)

(mM) Baby A Baby C
1.0 2.3 2.4
10.0 5.7 5.6

(9) Comment on the data.

10) Baby A is from an ethnic group in which hypoglycaemia at birth is associated with one
one of two mutations in SUR1 , both are single base pair changes.
How would you determine whether baby A carries either of the known SUR1 mutations.