Transient neonatal diabetes mellitus: a case report

Abstract

Neonatal diabetes mellitus (NDM) is defined as hyperglycemia in the first six months of life for at least two weeks and requiring insulin therapy. Although its incidence is 1 in 90000-160000 live births, its frequency rises to 1/30000 in societies such as our country where consanguineous marriages are common. NDM may be seen as transient (50-60%), permanent or as a part of syndromes. Clinical manifestations of NDM are intrauterine growth retardation, growth cessation, excessive urination, dehydration, and ketoacidosis. Since hyperglycemia may develop due to many different reasons in premature or low birth weight babies, difficulties and delays may occur in diagnosis. If the high blood glucose level lasts longer than 7-10 days after excluding other causes of transient hyperglycemia, it is recommended to suspect NDM and perform genetic examination, especially in infants with blood glucose above 250 mg/dL. Herein, a newborn, referred to our neonatal unit due to persistent hyperglycemia on the postnatal 15th day and diagnosed as transient NDM after excluding other causes of hyperglycemia, is presented due to the rarity of the disease.

Keywords

• Congenital
• neonatal diabetes mellitus
• transient
• diagnosis

Geçici neonatal diyabetes mellitus: bir olgu sunumu

Abstract

Neonatal diyabetes mellitus (NDM), yaşamın ilk altı ayında en az iki hafta süren ve insülin tedavisi gerektiren hiperglisemi olarak tanımlanır. Görülme sıklığı 90000-160000 canlı doğumda bir olmasına rağmen ülkemiz gibi akraba evliliklerinin yaygın olduğu toplumlarda görülme sıklığı 1/30000'e kadar çıkmaktadır. NDM geçici (%50-60), kalıcı veya sendromların bir parçası olarak görülebilir. NDM'nin klinik belirtileri intrauterin büyüme geriliği, büyümenin durması, aşırı idrara çıkma, dehidratasyon ve ketoasidozdur. Prematüre veya düşük doğum ağırlıklı bebeklerde birçok farklı nedene bağlı olarak hiperglisemi gelişebileceğinden tanıda zorluklar ve gecikmeler yaşanabilmektedir. Geçici hipergliseminin diğer nedenleri dışlandıktan sonra kan şekeri yüksekliği 7-10 günden uzun sürüyorsa özellikle kan şekeri 250 mg/dL'nin üzerinde olan bebeklerde NDM'den şüphelenilmesi ve genetik inceleme yapılması önerilir. Burada postnatal 15. günde inatçı hiperglisemi nedeniyle yenidoğan ünitemize başvuran ve diğer hiperglisemi nedenleri dışlandıktan sonra geçici NDM tanısı alan bir yenidoğan, hastalığın nadir görülmesi nedeniyle sunulmaktadır.

Keywords

• Konjenital
• neonatal diyabet
• geçici
• tanı

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