Transient Neonatal Diabetes Mellitus Managed with Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring

Abstract

Neonatal diabetes mellitus can be categorized as transient, permanent, or syndromic, and approximately half of the cases are transient. We present a case involving a term newborn who showed overt progression of transient neonatal diabetes mellitus, with complete remission within 6 months. On the second day of life, the patient pre sented with tachypnea, hyperglycemia, and decreased serum levels of Cpeptide and insulin. Continuous subcutaneous infusion of insulin and continuous glucose monitoring were well tolerated. The patient showed a normal growth pattern, with no hyperglycemic or hypoglycemic episodes at 6 months of age. As it is rare and often asymptomatic, hyperglycemia may be attributed to various factors, including intrauterine environment, perinatal stress, and diverse genetic background. There fore, consistent blood glucose monitoring and prompt early insulin therapy are crucial for any term newborns with persistent hyperglycemia, to prevent further diabetic complications. Moreover, continuous subcutaneous insulin infusion and the utilization of continuous glucose monitoring devices are the most effective and practical management strategies.

Transient Neonatal Diabetes Mellitus with an Unknown Cause in a 1-Month-Old Infant: A Case Report

“…In recent years, there have been documented cases using a continuous subcutaneous insulin infusion (CSII) in NDM treatment [14][15][16]. Our case report confirms that the CSII combined with the CGM system works successfully in children with TNDM who have unpredictable changes in their insulin demand from day to day.…”

Successful Termination of Insulin Therapy in Transient Neonatal Diabetes Mellitus

“…Sensor-augmented pump (SAP) therapy combines continuous subcutaneous insulin infusion (CSII) with continuous glucose monitoring (CGM). SAP therapy is thought to be useful in patients with type 1 diabetes and has been used in several patients with NDM in recent years [ 4 , 5 ]. We report our experience of using SAP therapy in a patient with TNDM, where the standard deviation (SD) of the mean sensor glucose values in CGM was a useful indicator for when to taper and terminate insulin therapy.…”