Abstract
In TNDM a delayed maturation of insulin secretion has been suggested. However, concentrations of C-peptide (C-pep) - a reliable measure of pancreatic B cell function - and of proinsulin in plasma (P) have not been reported. In 4 babies (birth weight 1800-1954 g, gestational age 32-37 weeks) with TNDM from day 5-11 of life, P-proinsulin, P-insulin IgG antibody (P-IAb) as well as serial measurements of P-glucose and P-C-pep were carried out. In 3 patients without IAb on admission, P-glucose was 38.7-64 mmol/l, P-proinsulin <1.2-2.2 pmol/l (ref.: 1.2-13 pmol/l). P-C-pep values were <0.06 and 0.06 nmol/l (ref.: 0.18-0.63 nmol/l), respectively, in patients I and II who had an insulin requirement of 4 i.u. per kg and 24h. In patient III, P-C-pep was 0.15 nmol/l initially and the insulin dose 2 i.u. per kg and 24h. Patient IV had an initial P-glucose of 16 mmol/l, a P-C-pep of 0.33 nmol/l, a P-IAb of 3.09 mU/ml, and a moderate insulin requirement (l i.u. per kg and 24h). In patients I, II, and III, the P-C-pep rose to reference levels concomitantly with a decrease in insulin requirement (withdrawal of insulin after 86, 88, and 15 days, resp.). In patient IV, P-C-pep remained at reference concentrations, the insulin requirement decreasing with a concurrent decrease in P-IAb {withdrawal of therapy after 68 days). Conclusion: P-C-pep and P-IAb - but not the initial P-glucose or birthweight - are of prognostic significance in the treatment of TNDM.
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Jacobsen, B., Nielsen, F., Pedersen, V. et al. RESIDUAL B CELL FUNCTION IN TRANSIENT NEONATAL DIABETES MELLITUS (TNDM). Pediatr Res 23, 115 (1988). https://doi.org/10.1203/00006450-198801000-00083
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DOI: https://doi.org/10.1203/00006450-198801000-00083
