Infantile onset diabetes mellitus in developing countries - India

Area of Science:

• Pediatrics
• Endocrinology
• Genetics

Background:

• Infantile onset diabetes mellitus (IODM) is a rare metabolic disorder in children under one year.
• It presents heterogeneously, often with diabetic ketoacidosis, and is frequently misdiagnosed.
• Monogenic causes, such as potassium channel mutations and Wolcott Rallison syndrome, are implicated.

Purpose of the Study:

• To review the literature on infantile onset diabetes mellitus (IODM) in India.
• To highlight diagnostic challenges and recent advancements in management.

Main Methods:

• Review of existing literature on infantile onset diabetes mellitus (IODM).
• Analysis of clinical presentation, genetic causes, and management strategies.

Main Results:

• 83% of IODM cases present with diabetic ketoacidosis; 67% are initially misdiagnosed.
• Potassium channel mutations (sulfonylurea-responsive) and Wolcott Rallison syndrome are common.
• Associated conditions include developmental delay and seizures.

Conclusions:

• Genetic diagnosis revolutionizes IODM management, enabling a switch from insulin to oral hypoglycemic agents in specific cases.
• Mortality rates in Indian neonatal diabetes studies reach 32.5%.