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Management of a case of transient neonatal diabetes mellitus using continuous glucose monitoring
Neonatal diabetes mellitus (NDM) is a very rare disorder and its diagnosis can be challenging especially in mild and transient cases. Herein, we describe a 2.4-kg female infant born at 38 wk of gestation who showed hyperglycemia (388 mg/dL) on Day 1. Intermittent blood sampling showed glucose concen...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society for Pediatric Endocrinology
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160458/ https://www.ncbi.nlm.nih.gov/pubmed/32313376 http://dx.doi.org/10.1297/cpe.29.77 |
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author | Iwata, Naoya Asui, Risa Mizumoto, Hiroshi Hata, Daisuke |
author_facet | Iwata, Naoya Asui, Risa Mizumoto, Hiroshi Hata, Daisuke |
author_sort | Iwata, Naoya |
collection | PubMed |
description | Neonatal diabetes mellitus (NDM) is a very rare disorder and its diagnosis can be challenging especially in mild and transient cases. Herein, we describe a 2.4-kg female infant born at 38 wk of gestation who showed hyperglycemia (388 mg/dL) on Day 1. Intermittent blood sampling showed glucose concentrations of 100–150 mg/dL on Day 2–5. However, continuous glucose monitoring (CGM) from Day 7 revealed hyperglycemia (> 200 mg/dL) after every feeding. The patient required low-dose (0.1–0.2 U/kg/d) insulin therapy for a short period (7 d). During the treatment, hypoglycemic (< 50 mg/dL) events were not detected by real- time CGM. Follow-up CGM from Day 32 showed normoglycemia for 3 full days; therefore, we ascertained that the diabetes had been transient. Later genetic analysis revealed an abnormal methylation pattern on chromosome 6q24, which is the most frequent cause of transient NDM. Most cases of 6q24-related NDM relapse after puberty, implying that long term follow up is required. We speculate that the NDM in this case might not have been diagnosed without CGM. This report highlights the usefulness of CGM for the initial diagnosis, monitoring during insulin therapy, and confirmation of improvement in patients with transient NDM. |
format | Online Article Text |
id | pubmed-7160458 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Japanese Society for Pediatric Endocrinology |
record_format | MEDLINE/PubMed |
spelling | pubmed-71604582020-04-20 Management of a case of transient neonatal diabetes mellitus using continuous glucose monitoring Iwata, Naoya Asui, Risa Mizumoto, Hiroshi Hata, Daisuke Clin Pediatr Endocrinol Case Report Neonatal diabetes mellitus (NDM) is a very rare disorder and its diagnosis can be challenging especially in mild and transient cases. Herein, we describe a 2.4-kg female infant born at 38 wk of gestation who showed hyperglycemia (388 mg/dL) on Day 1. Intermittent blood sampling showed glucose concentrations of 100–150 mg/dL on Day 2–5. However, continuous glucose monitoring (CGM) from Day 7 revealed hyperglycemia (> 200 mg/dL) after every feeding. The patient required low-dose (0.1–0.2 U/kg/d) insulin therapy for a short period (7 d). During the treatment, hypoglycemic (< 50 mg/dL) events were not detected by real- time CGM. Follow-up CGM from Day 32 showed normoglycemia for 3 full days; therefore, we ascertained that the diabetes had been transient. Later genetic analysis revealed an abnormal methylation pattern on chromosome 6q24, which is the most frequent cause of transient NDM. Most cases of 6q24-related NDM relapse after puberty, implying that long term follow up is required. We speculate that the NDM in this case might not have been diagnosed without CGM. This report highlights the usefulness of CGM for the initial diagnosis, monitoring during insulin therapy, and confirmation of improvement in patients with transient NDM. The Japanese Society for Pediatric Endocrinology 2020-04-16 2020 /pmc/articles/PMC7160458/ /pubmed/32313376 http://dx.doi.org/10.1297/cpe.29.77 Text en 2020©The Japanese Society for Pediatric Endocrinology This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Iwata, Naoya Asui, Risa Mizumoto, Hiroshi Hata, Daisuke Management of a case of transient neonatal diabetes mellitus using continuous glucose monitoring |
title | Management of a case of transient neonatal diabetes mellitus using continuous
glucose monitoring |
title_full | Management of a case of transient neonatal diabetes mellitus using continuous
glucose monitoring |
title_fullStr | Management of a case of transient neonatal diabetes mellitus using continuous
glucose monitoring |
title_full_unstemmed | Management of a case of transient neonatal diabetes mellitus using continuous
glucose monitoring |
title_short | Management of a case of transient neonatal diabetes mellitus using continuous
glucose monitoring |
title_sort | management of a case of transient neonatal diabetes mellitus using continuous
glucose monitoring |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160458/ https://www.ncbi.nlm.nih.gov/pubmed/32313376 http://dx.doi.org/10.1297/cpe.29.77 |
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