PANCREATIC ISLET CELL FUNCTION AND METABOLIC CONTROL IN AN INFANT WITH PERMANENT NEONATAL DIABETES
- 1 March 1983
- journal article
- case report
- Published by Wiley in Acta Paediatrica
- Vol. 72 (2), 303-307
- https://doi.org/10.1111/j.1651-2227.1983.tb09718.x
Abstract
A girl with typical clinical manifestations of neonatal diabetes was observed for 16 months with consecutive evaluations of pancreatic beta- and alpha-cell function and metabolic control. At the diagnosis both the plasma immunoreactive insulin (IRI) and C-peptide concentrations were inappropriate for the contemporaneous hyperglycemia. During the follow-up, the C-peptide fell twice below the detection limit but the beta-cell function recovered partially on both occasions. Based on 24-hour urinary C-peptide excretion, the endogenous insulin secretion was less than 10% of that in non-diabetic infants. When diagnosed the patient had plasma immunoreactive glucagon (IRG) and glucagon-like immunoreactivity (GLI) concentrations below the reference range for normal neonates. The IRG normalised within the first month, while the GLI increased to a level exceeding the reference range. Hemoglobin A1 had already risen at the time of diagnosis and subsequently rose to a level indicating poor metabolic control. The findings indicate an immature function of both beta- and alpha-cells at the diagnosis with the alpha-cells maturing within the first month. The recovery of the beta-cell function, after two failures in this patient with permanent neonatal diabetes, suggests that the beta-cell damage was at least partially reversible.Keywords
This publication has 11 references indexed in Scilit:
- Plasma C-peptide and insulin in neonates, infants, and childrenThe Journal of Pediatrics, 1981
- Glycosylated Hemoglobin and Diabetes MellitusLaboratory Medicine, 1981
- Residual β-Cell Function and Islet Cell Antibodies in Diabetic ChildrenPediatric Research, 1981
- Prevalence of permanent congenital diabetes mellitusDiabetologia, 1980
- Glycosylated hemoglobins: increased glycosylation of hemoglobin A in diabetic patientsDiabetes, 1979
- A rapid micro-scale method for the measurement of haemoglobin A1(a+b+c)Diabetologia, 1978
- NEONATAL DIABETESThe Lancet, 1974
- Presence of pancreatic glucagon in the portal plasma of human neonates. Differences in the insulin and glucagon responses to glucose between normal infants and infants from diabetic mothersDiabetologia, 1972
- Radioimmunological determination of pancreatic and gut glucagon in plasmaDiabetologia, 1971
- Congenital Temporary Diabetes MellitusBMJ, 1962