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Continuous subcutaneous insulin infusion in neonatal diabetes mellitus

Kupper A Wintergerst1, Susan Hargadon, Helen Y Hsiang

  • 1Department of Pediatric Endocrinology and Diabetes, Stanford University, Stanford Medical Center, Stanford, CA, USA.

Pediatric Diabetes
|December 17, 2004
PubMed

Insights

A premature infant with pancreatic agenesis developed diabetes shortly after birth. Continuous subcutaneous insulin infusion managed the condition for over two years with minimal complications.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Developmental Biology

Background:

  • Severe intrauterine growth retardation (IUGR) can impact fetal development.
  • Congenital anomalies of the pancreas are rare but can lead to metabolic disorders.
  • Neonatal diabetes mellitus requires timely diagnosis and management.

Observation:

  • A 1.2-kg premature male infant presented with severe IUGR.
  • Diabetes mellitus was diagnosed on day 2 of life.
  • Computed tomography (CT) revealed agenesis of the dorsal pancreatic anlage, specifically the absence of the pancreatic tail.

Findings:

  • The infant was successfully managed with continuous subcutaneous insulin infusion (CSII) for 26 months.
  • Complications, notably hypoglycemia, were minimal during the treatment period.
  • This case highlights the feasibility of long-term insulin therapy in neonatal diabetes due to pancreatic agenesis.

Implications:

  • Early diagnosis and intervention are crucial for managing neonatal diabetes.
  • CSII can be an effective and safe long-term treatment strategy for infants with pancreatic agenesis.
  • Understanding pancreatic development is key to identifying and treating congenital metabolic disorders.

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