In children under 6 months of age, type 1 diabetes mellitus (DM 1) is extremely rare. However, in the first week after birth, transient diabetes mellitus may appear, which disappears spontaneously after a few weeks. This syndrome is most often observed in children with low body weight for their gestational age. It is characterized by hyperglycemia and severe glucosuria , leading to severe dehydration and sometimes metabolic acidosis , but with practically no ketonemia and ketonuria . Insulin Reactions to Glucose and Tolbutamide reduced or completely absent, although the plasma insulin concentration is normal. After spontaneous remission, the insulin response to the corresponding stimuli is fully restored. In all likelihood, the basis of this syndrome is a delay in the maturation of beta cells. Often, patients find anomalies of chromosome 6 .
There are known cases of transient diabetes in the second and third child in the same family. Sometimes patients with transient diabetes in infancy later develop classic diabetes 1. The causal relationship between these diseases is questionable.
Transient diabetes mellitus syndrome in newborns should be distinguished from high hyperglycemia , which may be the result of hypertensive dehydration . The latter usually develops at a later age and is quickly eliminated by the introduction of hypotonic solutions; insulin requirement is minimal.
In acute manifestations of diabetes in newborns, insulin must be administered . The introduction of 1-2 units / day of medium-duration insulin (in 2 divided doses) quickly improves the condition of the child and normalizes its growth and body weight. If episodes of hypoglycemia occur, as well as after 2 months of age, insulin doses can be gradually reduced.