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Transient Neonatal Diabetes Mellitus followed by recurrent asymptomatic hypoglycaemia: a case report

Transient Neonatal Diabetes Mellitus followed by recurrent asymptomatic hypoglycaemia: a case report
Transient Neonatal Diabetes Mellitus followed by recurrent asymptomatic hypoglycaemia: a case report
Background: Transient Neonatal Diabetes Mellitus is the commonest cause of diabetes presenting in the first week of life. Majority of infants recover by 3 months of age but are predisposed to developing type 2 diabetes later on in life. This condition is usually due to genetic aberrations at the 6q24 gene locus, and can be sporadic or inherited. This disorder has three phases: neonatal diabetes, apparent remission, relapse of diabetes.

Case Presentation: Our case, a neonate presented with low birth weight and growth retardation along with the metabolic profile consistent with transient diabetes mellitus at birth. We report a novel clinical observation of recurrent asymptomatic hypoglycaemia detected on pre-feed blood glucose level monitoring in our case with transient neonatal diabetes mellitus at 6 weeks of age, 4 weeks after the remission of diabetes mellitus.

Conclusion: This case demonstrates that neonates in remission following transient diabetes mellitus can present with recurrent asymptomatic hypoglycaemia without any other obvious congenital malformations seen. This asymptomatic hypoglycaemia may persist for weeks and may be missed if pre-feed blood glucose level monitoring is not done in these infants. Also, these infants may require an aggressive enteral feeding regimen with high glucose delivery rate to maintain normoglycemia.
transient neonatal diabetes mellitus, 6q24 gene defect, hypoglycaemi
1471-2431
1-4
Priyadarshi, Archana
b4db36d5-bea9-40d3-b1da-e119b7b7ce89
Verge, Charles F.
309543a9-84a7-4e14-a91d-307903b1d643
Vandervliet, Leah
4b974c0e-2e5e-4e3e-9c60-06642ee3d7d6
Mackay, Deborah J.G.
588a653e-9785-4a00-be71-4e547850ee4a
Bolisetty, Srinivas
c75f5954-a012-4acd-a428-63347807b291
Priyadarshi, Archana
b4db36d5-bea9-40d3-b1da-e119b7b7ce89
Verge, Charles F.
309543a9-84a7-4e14-a91d-307903b1d643
Vandervliet, Leah
4b974c0e-2e5e-4e3e-9c60-06642ee3d7d6
Mackay, Deborah J.G.
588a653e-9785-4a00-be71-4e547850ee4a
Bolisetty, Srinivas
c75f5954-a012-4acd-a428-63347807b291

Priyadarshi, Archana, Verge, Charles F., Vandervliet, Leah, Mackay, Deborah J.G. and Bolisetty, Srinivas (2015) Transient Neonatal Diabetes Mellitus followed by recurrent asymptomatic hypoglycaemia: a case report. BMC Pediatrics, 15 (200), 1-4. (doi:10.1186/s12887-015-0512-7). (PMID:26631065)

Record type: Article

Abstract

Background: Transient Neonatal Diabetes Mellitus is the commonest cause of diabetes presenting in the first week of life. Majority of infants recover by 3 months of age but are predisposed to developing type 2 diabetes later on in life. This condition is usually due to genetic aberrations at the 6q24 gene locus, and can be sporadic or inherited. This disorder has three phases: neonatal diabetes, apparent remission, relapse of diabetes.

Case Presentation: Our case, a neonate presented with low birth weight and growth retardation along with the metabolic profile consistent with transient diabetes mellitus at birth. We report a novel clinical observation of recurrent asymptomatic hypoglycaemia detected on pre-feed blood glucose level monitoring in our case with transient neonatal diabetes mellitus at 6 weeks of age, 4 weeks after the remission of diabetes mellitus.

Conclusion: This case demonstrates that neonates in remission following transient diabetes mellitus can present with recurrent asymptomatic hypoglycaemia without any other obvious congenital malformations seen. This asymptomatic hypoglycaemia may persist for weeks and may be missed if pre-feed blood glucose level monitoring is not done in these infants. Also, these infants may require an aggressive enteral feeding regimen with high glucose delivery rate to maintain normoglycemia.

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Accepted/In Press date: 24 November 2015
Published date: 2 December 2015
Keywords: transient neonatal diabetes mellitus, 6q24 gene defect, hypoglycaemi
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 384970
URI: http://eprints.soton.ac.uk/id/eprint/384970
ISSN: 1471-2431
PURE UUID: 6b7f6bbb-5c7c-4143-b712-8045d390e2db
ORCID for Deborah J.G. Mackay: ORCID iD orcid.org/0000-0003-3088-4401

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Date deposited: 14 Jan 2016 14:18
Last modified: 15 Mar 2024 03:01

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Contributors

Author: Archana Priyadarshi
Author: Charles F. Verge
Author: Leah Vandervliet
Author: Srinivas Bolisetty

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