Neonatal onset diabetes mellitus: clinical analysis of 21 cases / 中国新生儿科杂志

ABSTRACT

Objective:To study the clinical characteristics of neonatal onset of diabetes mellitus.Methods:Neonatal onset diabetes mellitus infants admitted to Children's Hospital of Fudan University from January 2003 to December 2020 were selected for retrospective analysis. All clinical characteristics including the basic conditions, family history, clinical manifestations, laboratory examination, diagnosis and treatment were recorded and analyzed.Results:There were 21 cases of diabetes mellitus diagnosed during neonatal period, including 13 males and 8 females. There were 16 term infants and 5 premature infants with gestational age between 34 weeks and 40 weeks. The birth weight ranged from 1 420 g to 3 450 g, including 14 low birth weight infants, 2 very low birth weight infants and 13 small for gestational age infants. Four infants had family history of diabetes. All diabetic infants with onset time within 28 days after birth included 10 cases within 10 days, 4 cases between 11 days and 20 days, 7 cases between 21 days and 28 days. Hyperglycemia was the main feature of 21 infants, and their blood glucose was ≥11.1 mmol/L for many times, with a maximum of 41.98 mmol/L. Only 2 cases had ketoacidosis and 8 cases were complicated with infections. Genetic testing was performed in 6 neonates,2 cases of ABCC8 gene pathogenic variant, 1 case of KCNJ11 and 1 case of INS pathogenic variant, and 2 cases of negative results. Insulin was mainly used in the initial stage of treatment, and then orally glibenclamide was taken in 9 infants. After treatment, 15 patients had stable blood glucose and were discharged with medication. 5 infants were withdrawn the treatment and discharged, and 1 infant combined with other serious illness died after giving up the treatment by the parents.Conclusions:When diabetes is diagnosed during the neonatal period, it is helpful to choose the appropriate treatment and get good results.