Neonatal
A rare form of diabetes diagnosed in the first six months of life, distinct from type 1 and type 2 diabetes. It is caused by genetic mutations that affect insulin production, leading to high blood glucose levels.
There are two main types:
- Transient Neonatal Diabetes Mellitus (TNDM) - this is the more common type, accounting for 50-60% of NDM cases. It is characterised by diabetes that appears in the first few months of life but resolves on its own, usually before the baby's first birthday.
- Permanent Neonatal Diabetes Mellitus (PNDM) - Permanent neonatal diabetes as expected, lasts forever and accounts for 40–50% of all cases.
Please note, some people may experience a recurrence of the condition later in life, often during adolescence.
Key characteristics include:
- Onset in the first six months of life - unlike type 1 diabetes, which typically appears later, NDM manifests within the first six months of life.
- Hyperglycaemia - elevated blood glucose levels are a hallmark of NDM.
- Insulin deficiency - the pancreas either does not produce enough insulin or produces none.
- Dehydration - this is a common symptom due to the body losing fluids through frequent urination.
- Excessive thirst (Polydipsia)- as the body tries to compensate for fluid loss, babies may exhibit increased thirst.
- Frequent urination (Polyuria)- this is a direct result of the body trying to eliminate excess glucose through urine.
- Slowed foetal growth and low birth weight - these can be early indicators, especially in the case of permanent neonatal diabetes.
- High blood sugar (Hyperglycaemia) - is detected through blood or urine tests.
- Excessive fluid loss - infants may experience overall dehydration due to the condition.
- Macroglossia - An unusually large tongue can be a physical characteristic in some cases of neonatal diabetes.
- Umbilical hernia - An umbilical hernia appears as a painless lump in or near the belly button (navel). It may get bigger when laughing, coughing, crying or going to the toilet and may shrink when relaxing or lying down.
- Developmental delay - delays in reaching developmental milestones.
- Weak muscle tone (Hypotonia) - presents in infants as floppiness.
- Seizures - in severe cases seizures can occur.
If an infant is experiencing any of these symptoms, please visit your GP
- Medications - stimulating the pancreas to release more insulin and can be effective in cases with specific genetic
- Insulin - injections are necessary for infants whose diabetes is not well-controlled.
Transient neonatal diabetes resolves spontaneously in infancy but can recur later.
Permanent neonatal diabetes requires ongoing management.
Genetic testing is available for children and siblings of people with Type 1 diabetes; it is a tool for assessing risk.
If a result is positive for high-risk genes or autoantibodies, this indicates an increased likelihood of developing the condition, but it does not guarantee it.
The testing is combined with autoantibody screening to provide a more complete picture of risk.
- Genetic Risk Score (GRS): a DNA test that calculates a child's overall genetic risk by analysing multiple Type 1 diabetes -susceptibility genes. The higher the score, the greater the likelihood of developing the condition.
- Autoantibody Testing: a blood test that looks for autoantibodies, which are markers that show the immune system has begun its attack on the insulin-producing cells in the pancreas.
- High Risk: the presence of two or more autoantibodies indicates a very high risk of developing T1D in the future.
- Progression Stages: finding autoantibodies defines Stage 1 T1D, even before symptoms appear. Stage 2 is diagnosed when there are two or more antibodies along with abnormal blood sugar levels.
The ELSA Study is a UK-based program screening children aged 3–13 for type 1 diabetes.
Children aged 3-13 years can have a simple finger stick blood test to find out their risk of developing type 1 diabetes in the future. This is open to families living in England, Scotland, Wales, and Northern Ireland.
Shrewsbury & Telford Hospital
Shropshire has five midwifery led units (MLUs), where you will meet Midwives and Women’s Services Assistants (WSAs) who will care for you throughout your pregnancy.
Midwives who work in MLUs are very experienced and have undergone additional training to manage emergency situations. The midwives have direct access 24 hours a day to obstetricians and neonatal staff, to discuss any problems that may occur. WSAs are all trained in breastfeeding skills and will assist you in the postnatal period.
Address: The Princess Royal Hospital, Telford, TF1 6TF
Telephone: 01952641222, Ext 5706
Diabetes UK offer a dedicated diabetes helpline for all people with diabetes, their family or friends, and people who are worried they might be at risk.
Call the confidential helpline to talk to their highly trained advisors who have counselling skills and an extensive knowledge of diabetes. They can provide information about the condition, take the time to talk things through and explore emotional, social, psychological or practical difficulties.
England, Wales and Northern Ireland
Call: 0345 123 2399, Monday to Friday, 9am to 6pm
Email: helpline@diabetes.org.uk