Transient Neonatal Diabetes Mellitus Managed with Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring

Neonatal diabetes mellitus (NDM) results from impaired insulin secretion. While rare, NDM presents complex challenges with regard to the management of glycemic control. NDM is classified as transient neonatal diabetes mellitus (TNDM) or permanent neonatal diabetes mellitus (PNDM). Determination of TNDM vs. PNDM is usually possible only after medical management has been initiated. Management of NDM begins with insulin; however, the correct dose, choice of formulation, and route of administration are complicated by the risk of neonatal hypoglycemia. For the first time, the successful management of TNDM in an extremely low birth weight (ELBW) neonate with the long-acting subcutaneous insulin analog, insulin glargine, is reported. In addition, potential pharmacokinetic barriers to treating ELBW neonates diagnosed with NDM with subcutaneous insulin products are discussed.

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Successful treatment of young infants presenting neonatal diabetes mellitus with continuous subcutaneous insulin infusion before genetic diagnosis

Acta Diabetologica ◽

10.1007/s00592-015-0828-7 ◽

2016 ◽

Vol 53 (4) ◽

pp. 559-565 ◽

Cited By ~ 11

Author(s):

Ivana Rabbone ◽

Fabrizio Barbetti ◽

Marco Marigliano ◽

Riccardo Bonfanti ◽

Elvira Piccinno ◽

...

Keyword(s):

Diabetes Mellitus ◽

Successful Treatment ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Genetic Diagnosis ◽

Neonatal Diabetes ◽

Neonatal Diabetes Mellitus ◽

Subcutaneous Insulin ◽

Young Infants

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An oral sulfonylurea in the treatment of transient neonatal diabetes mellitus

Clinical Therapeutics ◽

10.1016/j.clinthera.2009.04.003 ◽

2009 ◽

Vol 31 (4) ◽

pp. 816-820 ◽

Cited By ~ 10

Author(s):

Lindsey A. Loomba-Albrecht ◽

Nicole S. Glaser ◽

Dennis M. Styne ◽

Andrew A. Bremer

Keyword(s):

Diabetes Mellitus ◽

Neonatal Diabetes ◽

Neonatal Diabetes Mellitus ◽

Transient Neonatal Diabetes Mellitus ◽

Transient Neonatal Diabetes

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Epidemiological characterization of diabetic patients on therapy with continuous subcutaneous insulin infusion and continuous glucose monitoring in real time

Endocrinología y Nutrición (English Edition) ◽

10.1016/j.endoen.2015.11.006 ◽

2015 ◽

Vol 62 (9) ◽

pp. 451-457

Author(s):

Natalia Aristizábal ◽

Alex Ramírez ◽

Jaime Hincapié-García ◽

Estefany Laiton ◽

Carolina Aristizábal ◽

...

Keyword(s):

Real Time ◽

Continuous Glucose Monitoring ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Glucose Monitoring ◽

Diabetic Patients ◽

Subcutaneous Insulin ◽

Epidemiological Characterization

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Differences between Transient Neonatal Diabetes Mellitus Subtypes can Guide Diagnosis and Therapy

Acta Endocrinologica ◽

10.1530/eje-20-1030 ◽

2021 ◽

Author(s):

Riccardo Bonfanti ◽

Dario Iafusco ◽

Ivana Rabbone ◽

Giacomo Diedenhofen ◽

Carla Bizzarri ◽

...

Keyword(s):

Diabetes Mellitus ◽

Clinical Features ◽

Umbilical Hernia ◽

Neonatal Diabetes ◽

Pharmacological Therapy ◽

Neonatal Diabetes Mellitus ◽

Data Set ◽

Transient Neonatal Diabetes Mellitus ◽

Remission Of Diabetes ◽

Transient Neonatal Diabetes

Objective: Transient neonatal diabetes mellitus (TNDM) is caused by activating mutations in ABCC8 and KCNJ11 genes (KATP/TNDM) or by chromosome 6q24 abnormalities (6q24/TNDM). We wanted to assess whether these different genetic aetiologies result in distinct clinical features. Design: Retrospective analysis of the Italian data set of patients with TNDM. Methods: Clinical features and treatment of 22 KATP/ TNDM patients and 12 6q24/TNDM patients were compared. Results: Fourteen KATP/TNDM probands had a carrier parent with abnormal glucose values, four patients with 6q24 showed macroglossia and/or umbilical hernia. Median age at diabetes onset and birth weight were lower in patients with 6q24 (1 week; -2.27 SD) than those with KATP mutations (4.0 weeks; -1.04 SD) (p=0.009 and p=0.007, respectively). Median time to remission was longer in KATP/TNDM than 6q24/TNDM (21.5 vs 12 weeks) (p=0.002). Two KATP/TNDM patients entered diabetes remission without pharmacological therapy. A proband with the ABCC8/L225P variant previously associated with permanent neonatal diabetes entered 7-year long remission after 1 year of sulfonylurea therapy. Seven diabetic individuals with KATP mutations were successfully treated with sulfonylurea monotherapy; four cases with relapsing 6q24/TNDM were treated with insulin, metformin or combination therapy. Conclusions: If TNDM is suspected, KATP genes should be analyzed first with the exception of patients with macroglossia and/or umbilical hernia. Remission of diabetes without pharmacological therapy should not preclude genetic analysis. Early treatment with sulfonylurea may induce long-lasting remission of diabetes in patients with KATP mutations associated with PNDM. Adult patients carrying KATP/TNDM mutations respond favourably to sulfonylurea monotherapy.

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