Neonatal Med.  2021 Feb;28(1):41-47. 10.5385/nm.2021.28.1.41.

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

• Kim MS
• Kim SE
• Lee NY
• Kim SK
• Kim SH
• Cho WK
• Cho KS
• Jung MH
• Suh BK
• Ahn MB

• KMID: 2513358
• DOI: http://doi.org/10.5385/nm.2021.28.1.41

Abstract

Neonatal diabetes mellitus can be categorized as transient, permanent, or syndromic, and approximately half of the cases are transient. We present a case involving a term newborn who showed overt progression of transient neonatal diabetes mellitus, with complete remission within 6 months. On the second day of life, the patient presented with tachypnea, hyperglycemia, and decreased serum levels of C-peptide and insulin. Continuous subcutaneous infusion of insulin and continuous glucose monitoring were well tolerated. The patient showed a normal growth pattern, with no hyperglycemic or hypoglycemic episodes at 6 months of age. As it is rare and often asymptomatic, hyperglycemia may be attributed to various factors, including intrauterine environment, perinatal stress, and diverse genetic background. Therefore, consistent blood glucose monitoring and prompt early insulin therapy are crucial for any term newborns with persistent hyperglycemia, to prevent further diabetic complications. Moreover, continuous subcutaneous insulin infusion and the utilization of continuous glucose monitoring devices are the most effective and practical management strategies.

Keyword

Diabetes mellitus, transient neonatal; Insulin infusion systems; Blood glucose self-monitoring; Diabetes mellitus; Infant, newborn

Figure

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  Figure 1. Successful transition to continuous subcutaneous insulin infusion (A) and real-time continuous glucose monitoring (B) on postpartum day 37.

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  Figure 2. Twenty-four-hour analysis of mean sensor glucose (MSG) and total daily dose of insulin (TDDI) for the following periods: (A) age 1 to 3 months and (B) age 4 to 5 months.

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