Infantile-onset diabetes mellitus: a 1-year follow-up study

Area of Science:

• Pediatric Endocrinology
• Genetics
• Metabolic Disorders

Background:

• Infantile-onset diabetes mellitus (IODM) is a rare condition requiring specialized evaluation.
• Understanding the diverse etiologies and clinical presentations of IODM is essential for appropriate management.
• Previous studies highlight the challenges in diagnosing and managing diabetes in the first year of life.

Purpose of the Study:

• To evaluate the clinical profiles and outcomes of infants diagnosed with diabetes mellitus before one year of age.
• To identify the underlying causes and associated syndromes in infantile-onset diabetes mellitus.
• To analyze the incidence trends and genetic associations of IODM.

Main Methods:

• Retrospective analysis of 12 infants with IODM presenting between January 2003 and December 2007.
• Comprehensive evaluation including detailed history, clinical examination, and laboratory investigations.
• Human leukocyte antigen (HLA) typing was performed for genetic analysis.

Main Results:

• The median age of onset was 2.5 months, with a higher prevalence in girls (9/12).
• Six infants had features of Wolcott-Rallison syndrome (WRS), four had type 1 diabetes, and one each had Fanconi-Bickel syndrome and maturity-onset diabetes of young.
• Predominant HLA alleles were DQ3 and DR15. Two children with WRS died; others are under follow-up.

Conclusions:

• The incidence of IODM appears to be increasing, with diverse syndromic associations.
• IODM is often associated with specific genetic syndromes, necessitating thorough etiological investigation.
• Early identification of underlying syndromes is critical for prognosis and management of infantile diabetes.