NEONATAL DIABETES MELLITUS REPORT OF 3 CASES

Neonatal diabetes mellitus is a very rare form of the disease and estimated to occure one in 500000 births. Neonatal diabetes differs from insulin- dependent diabetes and its course is highly variable. Some patients have permanent diabetes, but others have transient diabetes with or without later recurrence. Most of these infants are small for gestational age (SGA), and present with hyperglycemia and glycosuria, resulting in severe dehydration and metabolic acidosis but with only minimal or no ketonemia or ketonuria. During a period of five years, from May 1996 to Feb. 2001, three infants were discharged from Imam Hospital of Ahwaz, the center of Khozestan province, with diagnosis of diabetes mellitus. After measurment of blood sugar level for several times above 400mg/dl and exclusion of sepsis the diagnosis of neonatal diabetes was made. The mean age of patients at the time of admission was 28 days. Two patients were admitted for respiratory distress and another one for inadequate weigh gain. Two of them were SGA. One of the cases who had severe growth retardation at birth, was evaluated for insufficiency of exocrine pancreas. No abnormal finding was observed. No facial dysmorphism or foot abnormality was noted. One patient had HLA DR3 haplotype. One patient was followed for 2.5 years, and another subjects, who have been followed, till now have required insulin therapy.