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An assessment of pancreatic endocrine function and insulin sensitivity in patients with transient neonatal diabetes in remission.
Arch Dis Child Fetal Neonatal Ed. 2004 Jul; 89(4):F341-3.AD

Abstract

AIMS

To examine derived indices of beta cell function, peripheral insulin sensitivity, and the pancreatic response to intravenous glucose loading in children with a previous history of transient neonatal diabetes currently in remission, repeated after a period of two or more years.

METHODS

The standard intravenous glucose tolerance test (IVGTT) was used to measure the first phase insulin response (FPIR) cumulatively at one and three minutes. In addition, fasting insulin and glucose values were used to estimate insulinogenic indices (beta cell function) and QUICKI (insulin sensitivity).

PATIENTS

Six patients with known previous transient neonatal diabetes currently in remission with no exogenous insulin requirement were tested. Control data from 15 children of a similar age were available for derived fasting indices of beta cell functional capacity and insulin sensitivity.

RESULTS

One child had a subnormal insulin secretory response to intravenous glucose that remained abnormal two and four years later. The other children had relatively normal or entirely normal responses over two years. Measures of beta cell function and insulin sensitivity in the fasting state showed comparable results to those obtained from normal controls.

CONCLUSIONS

Most children with transient neonatal diabetes in remission have no evidence of beta cell dysfunction or insulin resistance in the fasting state, although they might have been expected to show subtle defects given the tendency to relapse in adolescence. Measures of insulin response to intravenous glucose loading are often normal but suggest future recurrence if profoundly abnormal.

Authors+Show Affiliations

St Michael's Hill, Bristol BS2 8BJ, UK. j.p.h.shield@bristol.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

15210671

Citation

Shield, J P H., et al. "An Assessment of Pancreatic Endocrine Function and Insulin Sensitivity in Patients With Transient Neonatal Diabetes in Remission." Archives of Disease in Childhood. Fetal and Neonatal Edition, vol. 89, no. 4, 2004, pp. F341-3.
Shield JP, Temple IK, Sabin M, et al. An assessment of pancreatic endocrine function and insulin sensitivity in patients with transient neonatal diabetes in remission. Arch Dis Child Fetal Neonatal Ed. 2004;89(4):F341-3.
Shield, J. P., Temple, I. K., Sabin, M., Mackay, D., Robinson, D. O., Betts, P. R., Carson, D. J., Cavé, H., Chevenne, D., & Polak, M. (2004). An assessment of pancreatic endocrine function and insulin sensitivity in patients with transient neonatal diabetes in remission. Archives of Disease in Childhood. Fetal and Neonatal Edition, 89(4), F341-3.
Shield JP, et al. An Assessment of Pancreatic Endocrine Function and Insulin Sensitivity in Patients With Transient Neonatal Diabetes in Remission. Arch Dis Child Fetal Neonatal Ed. 2004;89(4):F341-3. PubMed PMID: 15210671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An assessment of pancreatic endocrine function and insulin sensitivity in patients with transient neonatal diabetes in remission. AU - Shield,J P H, AU - Temple,I K, AU - Sabin,M, AU - Mackay,D, AU - Robinson,D O, AU - Betts,P R, AU - Carson,D J, AU - Cavé,H, AU - Chevenne,D, AU - Polak,M, PY - 2004/6/24/pubmed PY - 2004/7/20/medline PY - 2004/6/24/entrez SP - F341 EP - 3 JF - Archives of disease in childhood. Fetal and neonatal edition JO - Arch Dis Child Fetal Neonatal Ed VL - 89 IS - 4 N2 - AIMS: To examine derived indices of beta cell function, peripheral insulin sensitivity, and the pancreatic response to intravenous glucose loading in children with a previous history of transient neonatal diabetes currently in remission, repeated after a period of two or more years. METHODS: The standard intravenous glucose tolerance test (IVGTT) was used to measure the first phase insulin response (FPIR) cumulatively at one and three minutes. In addition, fasting insulin and glucose values were used to estimate insulinogenic indices (beta cell function) and QUICKI (insulin sensitivity). PATIENTS: Six patients with known previous transient neonatal diabetes currently in remission with no exogenous insulin requirement were tested. Control data from 15 children of a similar age were available for derived fasting indices of beta cell functional capacity and insulin sensitivity. RESULTS: One child had a subnormal insulin secretory response to intravenous glucose that remained abnormal two and four years later. The other children had relatively normal or entirely normal responses over two years. Measures of beta cell function and insulin sensitivity in the fasting state showed comparable results to those obtained from normal controls. CONCLUSIONS: Most children with transient neonatal diabetes in remission have no evidence of beta cell dysfunction or insulin resistance in the fasting state, although they might have been expected to show subtle defects given the tendency to relapse in adolescence. Measures of insulin response to intravenous glucose loading are often normal but suggest future recurrence if profoundly abnormal. SN - 1359-2998 UR - https://www.unboundmedicine.com/medline/citation/15210671/An_assessment_of_pancreatic_endocrine_function_and_insulin_sensitivity_in_patients_with_transient_neonatal_diabetes_in_remission_ L2 - http://fn.bmj.com/cgi/pmidlookup?view=long&pmid=15210671 DB - PRIME DP - Unbound Medicine ER -