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Question :

Posted On : 12 Feb 2007

I saw a 3 month patient with acidotic breathing and fever. There was no cough or any respiratory complaint. On investigating his blood sugar was 317mg Percent, urine sugar plus plus plus , no ketone bodies. Is there an entity like transient neonatal diabetes mellitus? Please tell about course of the illness, management, prognosis and other details. Thanks.

Expert Answer :

No expert answer available.

Answer Discussion :

doaa1973

transient neonatal hyperglycemia also pseudodiabetis occurs in SMG rarly proceed to DM in childhood there are many theories infection,immaturity,etc.
the treatment is fluid,insulin if needed 1-3unit-kg-day for 6-8days then gradual tapering.serum level of insulin well help in follow up.
other causes,dehydration,convulsion,intracranial hemorrage,sepsis VLBW

18 years ago

pediatriconcall

Was the child given a bolus of dextrose? Though one may still suspect Transient neonatal diabetes, other inborn error of metabolism should be kept in mind such as propionic acidemia that can present with hyperglycemia and acidosis with ketacidosis. Also sepsis may lead to hyperglcemia and acidosis due to stress. Right now the child may need IVFluids along with insulin to control the acidosis as well as hyperglycemia. Keep a close watch on the blood sugar.

18 years ago

saeedelsadek

this goes with diabetes mellitus , absence of ketonuria does not rule out DM possibly due to availability of the substrate,follow up is needed for possibility of persistence.

18 years ago

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