Ming Yeh Lee, Anna L Gloyn, David M Maahs, Priya Prahalad
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引用次数: 0
摘要
新生儿糖尿病(NDM)是一种单基因型糖尿病。新生儿皮下注射胰岛素治疗高血糖具有挑战性,因为该人群喂养频繁,每次喂养的牛奶摄入量不同,胰岛素剂量要求低,低血糖和相关并发症的风险高。我们报告了一个先证者的NDM病例,最初表现为局灶性癫痫和糖尿病酮症酸中毒,这是由于β细胞钾ATP通道基因KCNJ11 c.679G > a (p.E227K)的病理突变。我们描述了连续血糖监测(CGM)、胰岛素泵、自动胰岛素输送系统和远程患者监测技术的使用,以促进从胰岛素到口服磺脲的快速和安全的门诊交叉滴定。我们的病例强调了这些技术对患有糖尿病的婴儿的安全性和有效性,包括通过缩短住院时间改善血糖、生活质量和成本效益。
Management of Neonatal Diabetes due to a KCNJ11 Mutation with Automated Insulin Delivery System and Remote Patient Monitoring.
Neonatal diabetes mellitus (NDM) is a monogenic form of diabetes. Management of hyperglycemia in neonates with subcutaneous insulin is challenging because of frequent feeding, variable quantity of milk intake with each feed, low insulin dose requirements, and high risk for hypoglycemia and associated complications in this population. We present a case of NDM in a proband initially presenting with focal seizures and diabetic ketoacidosis due to a pathologic mutation in the beta cell potassium ATP channel gene KCNJ11 c.679G > A (p.E227K). We describe the use of continuous glucose monitoring (CGM), insulin pump, automated insulin delivery system, and remote patient monitoring technologies to facilitate rapid and safe outpatient cross-titration from insulin to oral sulfonylurea. Our case highlights the safety and efficacy of these technologies for infants with diabetes, including improvements in glycemia, quality of life, and cost-effectiveness by shortening hospital stay.