Diabetes symptoms in babies: How to know if your infant is suffering from neonatal diabetes

Neonatal diabetes mellitus (NDM), develops within 6 months of the birth of a child and could be temporary or permanent. Know its signs and symptoms.

While most of us are aware about childhood diabetes which can affect children and adolescents, there is another type of diabetes which is common in newborns and very young children. Known as neonatal diabetes mellitus (NDM), it develops within 6 months of the birth of a child and could be temporary or permanent. Caused by gene mutation, children with these gene abnormalities may respond to oral sulphonyl urea (SU) tablet and may not require insulin injections. In childhood diabetes, however, which is basically type 1 diabetes, those affected require lifelong insulin injections to sustain life and good health after their pancreatic insulin reserve decreases to almost nothing. (Also read: Super unhealthy foods you should stop giving your children)

What is Neonatal diabetes

"Neonatal diabetes mellitus, sometimes known as NDM, usually develops before the age of six months, though it can sporadically set in up to a year after birth. Neonatal diabetes is categorised as one of the "monogenic" types of the disease, which means it results from a mutation (defect) in a single gene. Numerous gene mutations may contribute to the development of neonatal diabetes," says Dr Ranjit Unnikrishnan I, Dr. Mohan's Diabetes Specialities Centre, Vice Chairman & Consultant.

There are two types of neonatal diabetes:

1. TNDM, or transient neonatal diabetes

2. Permanent new-born diabetes (PNDM)

Transient neonatal diabetes (TNDM) is a kind of diabetes that appears before the age of six months but usually disappears before the kid turns one. However, the diabetes may frequently return during puberty or the early years of childhood. TNDM is caused by distinct gene mutations, and understanding which mutation the child has influences both the prognosis and treatment options.

Similar to Temporary Neonatal Diabetes (TNDM), PNDM typically manifests before the age of six months. However, unlike TNDM, PNDM persists beyond the first birthday and typically lasts a lifetime.

Symptoms of neonatal diabetes

In neonatal diabetes, as in other forms of diabetes, when blood glucose levels become high, some glucose leaves the body through urine. This causes many of the initial symptoms, which may include:

- Increased numbers of wet diapers

- Increased appetite

- Dehydration

- Failure to thrive

Sometimes children with neonatal diabetes get misdiagnosed as type 1 diabetes and this is the reason accurate genetic diagnosis can help many children with the disease go off insulin injections. Indeed, these children respond better to oral sulphonylrea drugs than to insulin.

Other signs of neonatal diabetes

"Children with neonatal diabetes can frequently have other associated abnormalities like developmental delay and delayed milestones, neurological deficits and even epileptic fits because the same mutations are seen in other organs like the nervous system. Once the child is started on the sulphonyl urea agent, the neurological symptoms may also remit," says Dr Unnikrishnan.

"However, it should be noted that not all PNDM is due to mutations in KCNJ11/ ABCC8, and also that not all mutations in KCNJ11/ABCC8 respond equally well to sulphonylureas. Therefore, the decision to switch a young child with diabetes from insulin to sulphonylureas should only be made by an experienced physician on the basis of a confirmed genetic diagnosis from a standard laboratory. Stopping insulin in a child who does not have sulphonylurea-responsive mutations may prove deleterious or even fatal," the expert warns.

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