NEONATAL DIABETES MELLITUS IN 2,5 MONTH OLD CHILDREN

Abstract

<div>Neonatal Diabetes mellitus (NDM) is a rare genetic disease (1 in 90,000 live births). It is</div><div>defined by the presence of severe hyperglycaemia associated with insufficient or no</div><div>circulating insulin, occurring mainly before 6 months of age and rarely between 6 months</div><div>and 1 year. Such hyperglycaemia requires either transient treatment with insulin in about</div><div>half of cases, or permanent insulin treatment. In transient NDM, growth-retarded infants</div><div>develop diabetes in the first few weeks of life, only to go into remission after a few months</div><div>with possible relapse to permanent diabetes usually around adolescence or in adulthood. In</div><div>permanent NDM, insulin secretory failure occurs in the late fetal or early postnatal period.</div><div>We present a case of 9 months old boy with neonatal diabetes mellitus since 2 months 15</div><div>days old. He had history of fever, polyuria, polydypsia, tachypnoe and diabetic ketoacidosis.</div><div>He came with hyperglycemia, positive urine ketone and acidosis. C-peptide result was low</div><div>(0,1 mg/dl). Patient was hospitalized for acute conditions according to DKA management</div><div>and continued with insulin subcutaneous. Neonatal diabetes mellitus was a rare condition.</div><div>The cardinal symptoms of NDM include hyperglycemia at birth, IUGR, failure to thrive,</div><div>dehydration, and, rarely, ketoacidosis. Treatment with insulin should be started immediately</div><div>after diabetes is diagnosed by persistent hyperglycemia or elevated glycated hemoglobin</div><div>(HbA1c). The prognosis is related to the severity of the disease, the degree of dehydration</div><div>and acidosis, as well the rapidity with which the disease is recognized and treated. Prognosis</div><div>also depends on metabolic control.</div><div>Keyword: neonatal, hyperglycemia, diabetes mellitus.</div>