Glycemic control indicator levels at diagnosis of neonatal diabetes mellitus: Comparison with other types of insulin-dependent diabetes mellitus

Pediatr Diabetes. 2017 Dec;18(8):767-771. doi: 10.1111/pedi.12481. Epub 2016 Dec 20.

Abstract

Background: Neonatal diabetes mellitus (NDM) is a monogenic insulin-dependent diabetes that develops within 6 months of age. The progression of hyperglycemia until diagnosis is unknown. Glycemic control indicators at diagnosis are useful to estimate the extent and duration of hyperglycemia. We recently established that age-adjusted glycated albumin (GA) is a useful indicator of glycemic control, regardless of age.

Objective: To compare the levels of various glycemic control indicators at diagnosis between NDM and other types of insulin-dependent diabetes mellitus.

Patients and methods: We included 8 patients with NDM, 8 with fulminant type 1 diabetes (FT1D), and 24 with acute-onset autoimmune type 1 diabetes (T1AD). Plasma glucose, glycated hemoglobin (HbA1c), GA, and age-adjusted GA (calculated as previously reported) were measured and compared.

Results: There were no significant differences in the plasma glucose levels of the group of patients with NDM and those with FT1D or T1AD. HbA1c and GA levels in the NDM group were not significantly different from those in the FT1D group, and both indicators were lower than those in the T1AD group. Age-adjusted GA levels in the NDM group did not differ significantly from those in the T1AD group, but were higher than those in the FT1D group.

Conclusions: These findings suggest that the time-course of plasma glucose elevation in NDM until diagnosis is similar to that in T1AD. In addition, the high age-adjusted GA value at diagnosis of NDM indicates that this test is useful for assessing chronic hyperglycemia in NDM.

Keywords: HbA1c; fulminant type 1 diabetes; glycated albumin; neonatal diabetes mellitus; type 1 diabetes.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / classification
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Serum Albumin / metabolism
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Serum Albumin
  • glycosylated serum albumin
  • hemoglobin A1c protein, human