NEONATAL HYPERGLYCEMIA AND DIABETES-MELLI TUS

Background. - Hyperglycemia in the neonate may be permanent or more fr equently transient. Its treatment is still debated. Patients and metho ds. - The files of 19 infants with hyperglycemia were retrospectively analysed. Their birth-weights were more than 900 g and their gestation al ages more than 27 weeks. Plasma glucose, insulin, C-peptide, islet- cell and insulin autoantibodies were measured in each patient. Results . - Blood glucose ranged from 1.2 to 10 g/l (mean: 5.05 +/- 1.0), betw een the second hour and the 60(th) day of life. Four infants presented with permanent neonatal diabetes mellitus: they were small for gestat ional age. Hyperglycemia was rioted from the first day of life. C-pept ide levels were less than 0.1 pmol/ml and autoantibodies were absent. Two sibs had hypothyroidism, one patient had unclassifiable chronic di arrhea plus renal disease, the fourth patient had ventricular septal d efect. Tile 15 other patients presented with a transient hyperglycemia that appeared lately (6.1 +/- 3.4 day of life). Hyperglycemia was ind uced by glucose infusion in five patients by potentially hyperglycemic drugs in jive others. C-peptide levels ranged from 0.01 to 0.76 pmol/ ml (mean 0.29 +/- 0.11). One patient and his mother had insulin antibo dies. Another patient had congenital heart abnormalities. Hyperglycemi a required insulin therapy in 17 cases (four with permanent and 13 wit h transient hyperglycemia). Conclusion. - There are no clinical or bio logical features permitting foresee the duration of neonatal neonatal hyperglycemia. Each patient with birth-weight below 2500 g should be g iven insulin when glucosemia remains above 1.3 gn and his weight does not increase.