Ultralente insulin treatment of transient neonatal diabetes mellitus

Mitamura, Ryo; Kimura, H.; Murakami, Yurika; Nagaya, Ken; Makita, Yoshio; Okuno, Akimasa

doi:10.1016/s0022-3476(96)70406-7

Cited by 22 publications

(10 citation statements)

References 6 publications

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“…Basal subcutaneous insulin (e.g. ultralente and isophane insulin) can provide background insulin requirement but has resulted in extremely variable levels of blood glucose control when adequate subcutaneous tissue is available 14,18,19 . This was the approach adopted for case 1, using a 10‐fold insulin dilution to facilitate dose titration.…”

Section: Discussionmentioning

confidence: 99%

Neonatal diabetes mellitus: Insulin pump as an alternative management strategy

Bharucha

Brown

McDonnell

et al. 2005

J Paediatrics Child Health

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Neonatal diabetes mellitus (hyperglycaemia within the first month of life, with an insulin requirement) may be transient or permanent. Management is complex, due to lack of subcutaneous fat and the need for small doses of insulin, and may be complicated by additional medical problems. Three cases are presented, the first of which was treated with conventional insulin therapy. The latter two were successfully treated with subcutaneous insulin pump therapy. We present suggested guidelines for treatment of neonatal diabetes, using this novel approach to management.

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Section: Discussionmentioning

confidence: 99%

Neonatal diabetes mellitus: Insulin pump as an alternative management strategy

Bharucha

Brown

McDonnell

et al. 2005

J Paediatrics Child Health

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“…Although this approach compared with CSII is less physiologic and provides less control on the amount of insulin administered, dosing insulin glargine every 12 h allows a short window of time to evaluate the pharmacokinetics and to better make dose adjustments. Mitamura et al 23 presented the case of an infant with TNDM who attained control of blood glucose concentration with ultralente insulin treatment without any episodes of hypoglycemia. Jeha et al 24 described three cases of successful management of TNDM with insulin glargine, suggesting this therapeutic approach because of its flat pharmacokinetic profile, which might prove useful in this condition.…”

Section: Treatment Of Neonatal Diabetes Mellitusmentioning

confidence: 99%

Treatment of Transient Neonatal Diabetes Mellitus: Insulin Pump or Insulin Glargine? Our Experience

Passanisi

TimpanaroTiziana

PrestiDonatella

et al. 2014

Diabetes Technology & Therapeutics

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Neonatal diabetes mellitus (NDM) results from impaired insulin secretion, occurring within the first 6 months of life. NDM is classified as transient NDM (TNDM) or permanent NDM. To date there are no universal guidelines regarding its management. Intravenous insulin infusion represents the first and most adequate therapeutic approach for sustained hyperglycemia, but this can provide only a short-term solution. Several factors should be taken into account in the choice of the long-term treatment. We describe our experience with two infants affected by TNDM. The first child was treated with continuous subcutaneous insulin infusion, whereas the second infant was treated with subcutaneous insulin glargine injections. Our experience shows that the two different therapeutic approaches, if properly managed, are equally effective.

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“…A variety of methods for providing insulin such as: intravenous infusion, short−acting and long−acting subcutaneous injections, or continuous subcutaneous insulin infusion (CSII) can be used (4). In a study by Mitamura et al (14), control of the blood glucose concentration in infants with TNDM was attained with ultralente insulin treatment without any episodes of hypoglycaemia. These authors recommended subcutaneous injection of ultralente insulin, rather than lente or isophane (NPH) insulin to avoid hypoglycaemia during treatment.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Diabetes Mellitus Accompanied by Diabetic Ketoacidosis and Mimicking Neonatal Sepsis: A Case Report

Abacı¹,

Razi²,

Özdemir³

et al. 2010

jcrpe

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Neonatal diabetes mellitus (DM) develops within the first six weeks of life with basic findings including dehydration, hyperglycaemia, and mild or no ketonemia/ketonuria. It can be either transient or permanent. Here, we report a case of a one−month−old infant with permanent neonatal diabetes, due to pancreatic hypoplasia, accompanied by diabetic ketoacidosis (DKA). The hyperglycaemia and ketoacidosis resolved by the 14th hour of treatment, consisting of IV insulin and rehydration. Subsequently, insulin treatment was continued with neutral protamine hagedorn (NPH) insulin. Breastfeeding was started and was continued at intervals of three hours. Following initiation of breastfeeding, the stools became watery, loose, yellow−green in color, and frequent (8−10 times a day). They contained no blood or mucus. Replacement of pancreatic enzymes resulted in decreased stool frequency. Neonatal DM due to pancreatic hypoplasia and associated with DKA may mimic sepsis and should be kept in mind in all newborns who present with fever, dehydration, and weight loss.Conflict of interest:None declared.

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Ultralente insulin treatment of transient neonatal diabetes mellitus

Cited by 22 publications

References 6 publications

Neonatal diabetes mellitus: Insulin pump as an alternative management strategy

Neonatal diabetes mellitus: Insulin pump as an alternative management strategy

Treatment of Transient Neonatal Diabetes Mellitus: Insulin Pump or Insulin Glargine? Our Experience

Neonatal Diabetes Mellitus Accompanied by Diabetic Ketoacidosis and Mimicking Neonatal Sepsis: A Case Report

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