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[Neonatal hyperglycemia and diabetes mellitus]
J Zeller1, M Voyer, P F Bougnères
1Service d'endocrinologie pédiatrique, hôpital Saint-Vincent-de-Paul, Paris, France.
Summary
Neonatal hyperglycemia can be permanent or transient, with no clear indicators to predict its duration. Infants under 2,500g with glucose above 1.3 g/l and no weight gain require insulin therapy.
Area of Science:
- Neonatalogy
- Endocrinology
- Pediatric Diabetes
Context:
- Neonatal hyperglycemia presents a diagnostic and therapeutic challenge.
- Distinguishing between transient and permanent forms is crucial for management.
- Current treatment strategies remain a subject of debate.
Purpose:
- To retrospectively analyze cases of neonatal hyperglycemia.
- To identify clinical and biological features differentiating permanent from transient forms.
- To establish management guidelines for neonatal hyperglycemia.
Summary:
- A retrospective analysis of 19 infants with hyperglycemia (birth-weight >900g, gestational age >27 weeks) was conducted.
- Four infants had permanent neonatal diabetes mellitus (small for gestational age, early onset, low C-peptide, absent autoantibodies).
- Fifteen infants had transient hyperglycemia (later onset, various triggers), with varying C-peptide levels and occasional autoantibodies.
Impact:
- No definitive clinical or biological markers predict the duration of neonatal hyperglycemia.
- Recommends insulin for infants <2,500g with glucose >1.3 g/l and poor weight gain.
- Highlights the need for individualized management of neonatal hyperglycemia.