Abstract
Diabetes mellitus is uncommon in infancy and newborn period. The two common forms seen are the transient and permanent forms of diabetes mellitus of the newborn. They have to be differentiated from the transient hyperglycemic states (Blood sugar >125 mg/dl) seen in newborns who receive parenteral glucose infusions and in those with septicemia and CNS disorders. Transient diabetes mellitus of the newborn (TDNB) is defined as hyperglycemia occurring within the first month of life lasting at least 2 weeks and requiring insulin therapy. Most of these cases resolve spontaneously by 4 months. It has a reported incidence of 1 in 45,000 to 60,000 live births. The most likely etiology is a maturational delay of cAMP mediated insulin release. The clinical features include small for datedness, proneness for birth asphyxia, open-eye alert facies, dehydration, emaciation, polyuria and poydipsia. These children are prone to septicemia and urinary tract infections. They have hyperglycemia, glucosuria, absent or mild ketonuria, low basal insulin, C-peptide and IGF-1 levels. Treatment consists of hydration and judicious administration of insulin with close monitoring. Thirty percent of these children are likely to develop permanent neonatal diabetes. Compared to transient form, permanent diabetes mellitus is uncommon. It is usually due to pancreatic dysgenesis often associated with other malformations and rarely due to type 1 diabetes mellitus. The diagnosis is based on the demonstration of both exocrine and endocrine pancreatic dysfunction. These children are managed as type 1 diabetes mellitus. They are prone to develop the vascular complications of diabetes at an earlier date.
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References
Von Muhlendahl KE, Herkenhoff H. Long-term course of neonatal diabetes.N Eng J Med 1995; 333: 704–8.
Rais N & Joshi M. Transient neonatal diabetes mellitus.Indian J Pediatr 1988; 55: 979–982.
Merchant R, Irani A, Nagar P. Transient diabetes mellitus in early infancy.Indian Pediatr 1985; 22: 529–531.
Pagliara AS, Karl IE, Kipnis DBet al. Transient neonatal diabetes: Delayed maturation of the pancreatic beta cell.J Pediatr 1973; 83: 97–100.
Popat YO, Jethwani MG, Vaidya HDet al. Diabetes mellitus in infancy.Indian Pediatr 1994; 31: 1005–1006.
Gentz JCH, Cornblath M. Transient diabetes of the newborn.Adv Pediatr 1969; 16: 345.
Ferguson AW, Milner RDG. Transient neonatal diabetes mellitus in sibs.Arch Dis Child 1970; 45: 80–83.
Coffey JD, Womach NC. Transient neonatal diabetes mellitus in half sisters.Am J Dis Child 1967; 113: 80–482.
Whiteford ML, Narendra A, White MPet al. Paternal uniparental disomy for chromosome 6 causes transient neonatal diabetes.J Med Genet 1997; 34 (2): 176–178.
Halliday HL, Reid MM, Hadden DR. C-peptide levels in transient neonatal diabetes.Diabet Med 1986; 3 (1): 80–81.
Blethen SI, White NH, Santiago JVet al. Plasma somatomedins, endogenous insulin secretion, and growth in transient neonatal diabetes mellitus.J Clin Endocrinol Metab 1981; 52: 144–147.
Romano AA. The infant of a diabetic mother and diabetes in the first year of life. In: Lifshit F, ed.Clinical Pediatric Endocrinology 567–81.
Battin M, Yong C, Phang Met al. Transient neonatal diabetes mellitus and macroglossia.J Perinatol 1996; 16 (4): 288–291.
Mitamura R, Kimura H, Murakami Yet al. Ultralente insulin treatment of transient neonatal diabetes mellitus.J Pediatr 1996; 128 (2): 268–270.
Kuna P, Addy DP. Transient neonatal diabetes mellitus.Am J Dis Child 1979; 133: 65–66.
Weimerskirch D, Klein DJ. Recurrence of insulin-dependent diabetes mellitus after transient neonatal diabetes: A report of two cases.J Pediatr 1993; 122: 598–600.
Soliman AT, Elzalabany MM, Bappal Bet al. Permanent neonatal diabetes mellitus: Epidemiology, mode of presentation, pathogenesis and growth.Indian J Pediatr 1999; 66: 363–73.
Bappal B, Raghpathy P, De Silva Vet al. Permanent neonatal diabetes mellitus: Clinical presentation and epidemiology in Oman.Arch Dis Child 1999; 80: F209–12.
Filler G, Amendt P, Von Bredow MAet al. Slowly deteriorating insulin secretion and C-peptide production characterizes diabetes in mellitus in infantile cystinosis.Eur J Pediatr 1998; 157: 738–42.
Dorchy H. Permanent neonatal diabetes mellitus lack of diabetic complications after a 20 year follow-up.Eur I Pediatr 1992; 151: 151.
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Menon, P.S.N., Khatwa, U.A. Diabetes mellitus in newborns and infants. Indian J Pediatr 67, 443–448 (2000). https://doi.org/10.1007/BF02859464
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DOI: https://doi.org/10.1007/BF02859464