Neonatal diabetes

[Francesco Cardona]

We currently have a case of neonatal diabetes on our ward. the baby is getting basal/bolus insulin therapy now. incidence is estimated at 1 in 500.000.

anyone of you have any experience with that?

We were happy to find this article:

http://www.nejm.org/doi/pdf/10.1056/NEJM199509143331105

[Stefan Johansson]

A rarity indeed!

I have not seen a "true" case, I remember one very preterm that we suspected for having neonatal diabetes, but it was "transient hyperglycemia", just less "transient" than it usually is.

Do you use microdialysis or regular venous/capill b-sugars to monitor insulin therapy?

[Francesco Cardona]

I guess it depends on what you would define as "true case". As I understand the literature any prolonged period (say weeks) of hyperglycemia qualifies for neonatal diabetes. If it stops within the first 3 months i would call it transient neonatal diabetes. But I do not know of any definitions, anyone else?

.. some more reading here: Temple et al. Transient neonatal diabetes - a disorder of imprinting

After two months of treatment we are finally seeing an improvement in insulin demand - so maybe (just to prove me wrong..) our's is just transitory as well. It was definitely severe SGA, so obviously there is a connection there...

Microdialysis would have been truly interesting, but we are only in the beginning of getting experience with that. We use capillary sugars and guide our subcutaneous pump with that.

[Devarajan]

We had a newborn with proved Neonatal Diabetes. He has done well so far - till the age of 3 years. Please contact Dr. Majeda Mohd. Abdul Rasoul at faculty of Medicine, Kuwait. Her contact details: <rasoulkt@yahoo.com>

Devarajan Viswanathan

(Formerly at Faculty of Medicine, Kuwait)