This may be because amino acids stimulate endogenous insulin secretion, potentially resulting in lower fasting blood glucose concentrations.97,98 Hyperglycaemia is associated with poor neurodevelopmental outcomes,99 and is difficult to manage in very preterm infants, either by decreasing glucose intake which risks deceleration of growth or treating with insulin with the associated risk of hypoglycemia.99 Hence, the lower risk of hyperglycaemia in infants with high protein intake might be of some clinical benefit for children born preterm. Here, INS is linked to Hypoglycemia.