Neonatal diabetes mellitus(NDM) is a disease that affects infants.Neonatal diabetes mellitus is a monogenic ( controlled by a single gene ) form of diabetes that occurs in the first 6 months of life.
Infants do not produce enough insulin, leading to an increase in glucose accumulation. It is a rare disease, occurring in only one in 100,000 to 500,000 live births,
There are two types of Neonatal diabetes mellitus –
(i) Permanent neonatal diabetes mellitus(PNDM)
(ii)Transient neonatal diabetes mellitus (TNDM)
Permanent neonatal diabetes mellitus is a life long condition. Transient neonatal diabetic mellitus is disappears during the infants stage but may reappear later in life.
The neonatal diabetes mellitus can be caused by abnormal pancreatic development, beta cells dysfunction or accelerated beta cell dysfunction.Each gene associated with NDM has a different inheritance pattern.
There are common symptoms an excessive thirst ( known as polydipsia ) and increased urination (known as polyuria) are common sign of diabetes. Excess sugar is excreted into their urine. This may lead to more frequent urination and lead to dehydration.
Dehydration effected areas of the body are the eyes, mouth, kidneys, heart and pancreas, other symptoms of dehydration includes Dehydration, thirst and dry mouth, dizziness and dark colored urine. In several cases of dehydration in diabetes shows low blood pressure, sunken eyes or rapid heart beat, water is needed to re-hydrate the body.If access water is not available, the body would not be able to pass excess glucose out of the blood by urine.
Is a diabetic complication that occurs when the body produce high levels of acid in the blood( Ketones).This effects the pancreas, fat cells and kidneys. The body of on diabetic individual will break down fat as fuel. This process produces a buildup of acids in the bloodstream known as Ketones, in which leads to Ketoacidosis. The symptoms of Ketoacidosis develop rapidly or within 24 hours. Symptoms of Ketoacidosis are excessive thirst, frequent urination, nausea or vomiting , stomach pain.
Intrauterine Growth Restrictions – Delayed growth puts the baby at risk of certain problems during pregnancy delivery and after birth. The problems are, baby’s birth weight is 90% less than normal weight, difficulty handling delivery, decreased oxygen levels, hypoglycemia ( low blood glucose ) & low resistance to infections.
Hypoglycemia characterized an extremely low blood glucose, usually less than 70mg/dl. Areas of the body that are affected, pancreas, kidneys and mental state.
Neonatal diabetes mellitus causes are inherited genetically from the mother or father of the infant. Different genetic inheritence or generatic mutations can lead to different diagnosis of neonatal diabetes mellitus.There are ddifferent types of inheritence of mutations.
(a) Autosomal Dominant – Every cells has two copies of each-gene-one gene coming from the mother andd one coming from the father. Autosomal dominant inheritance pattern is defined as a mutation that occurs in only copy of the gene. In an autosomal dominant inheritance, a child who has a parent with the mutation has a 50% possibility of inheriting the mutation.
(b) Autosomal Recessive – Autosomal recessive inheritance pattern is defined as a mutation present in both copies,if the gene in order for a person to be affected and each parent much pass on a mutated gene for a child to be affected. However, if an infant or child has only one copy, he or she are a carrier of the mutation. If both parents are carrier of the recessive gene mutation, each child have a 25% enhance of inheriting the gene.
(c) Spontaneous – A new mutation or change occuts within the gene.
(d) X-Linked – When a trait or disease happens in a person who has inherited a mutated gene on the X Chromosone (one of the sex Chromosome).
Approximately 50% ofPNDM are associated with the pottasium channel defects . There are diagnostic tests of NDM are :-
- Fasting plasma glucose test . -> Measures and diabetics blood glucose after the patients has gone 8 hours without eating . This test is used to detect diabetes or pre diabetes .
- Oral glucose tolerance test . -> measures an individual’s blood glucose after the patient has gone 8 hours without eating and two hours after having glucose containing beverage . This test can be used to diagnose diabetes or pre diabetes .
- Random Plasma test . -> The doctor checks one’s blood glucose without regard to when an individual may have eaten last meal . This test along with an evaluation of symptoms are used to diagnose diabetes but not pre-diabetes .
- Genetic Test of NDM -> Samples from foetus or child and both parents are needed for analysis . This test is needed in order to check if special attention is needed for the child care .
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