Abacı Ayhan, Razi Cem Hasan, Ozdemir Osman, Hızlı Samil, Kıslal Fatih, Argas Pınar Işık, Kabakuş Nimet
Kecioren Training Research Hospital, Department of Pediatric Endocrinology, Ankara, Turkey.
J Clin Res Pediatr Endocrinol. 2010;2(3):131-3. doi: 10.4274/jcrpe.v2i3.131. Epub 2010 Aug 8.
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 14(th) 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.
新生儿糖尿病（DM）在出生后的前六周内发病，基本表现包括脱水、高血糖以及轻度或无酮血症/酮尿症。它可以是暂时性的，也可以是永久性的。在此，我们报告一例因胰腺发育不全导致永久性新生儿糖尿病的1个月大婴儿病例，该婴儿伴有糖尿病酮症酸中毒（DKA）。通过静脉注射胰岛素和补液治疗，高血糖和酮症酸中毒在治疗的第14小时得到缓解。随后，继续使用中性鱼精蛋白锌胰岛素（NPH胰岛素）进行胰岛素治疗。开始母乳喂养，每隔三小时进行一次。开始母乳喂养后，大便变得水样、松散、黄绿色且频繁（每天8 - 10次）。大便中没有血液或黏液。补充胰酶后，大便频率降低。因胰腺发育不全导致且与DKA相关的新生儿糖尿病可能类似败血症，对于所有出现发热、脱水和体重减轻的新生儿都应予以考虑。
