ESPE Abstracts (2015) 84 P-3-1097

Experience in Insulin Pump Therapy in the Treatment of Neonatal Diabetes

Tlif Asieta,b, Chernyak Irinaa, Shtoda Irinaa, Golovenko Irinaa & Kondratyeva Elenab

aChildren’s Regional Clinical Hospital, Krasnodar, Russia; bKuban State Medical University, Krasnodar, Russia

Background: Neonatal diabetes (ND) at first 6 months and its frequency is one in 500 000 newborns. There are some difficulties in its treatment, due to low demand and high sensitivity to insulin.

Case presentation: We present the experience in insulin pump therapy treatment. A 13 days girl was taken to Regional Children’s Clinical Hospital in Krasnodar. It was the child from the1st pregnancy with toxicosis in the one st trimester, threat of termination in the 2nd trimester and with the – FPI – in the 3d trimester. The child was born of 2150 g on the 36th week of pregnancy. Due to reduced response and inspection, weak physiological reflexes, sluggish sucking and the 27 mmol/l hyperglycemia on the 12th day it was decided to start with i.v. insulin to 0.05 UN/kg per h via infusion pump. Having the lability of the DM currents, the tendency of the problem of injection of small doses of insulin with syringe pens and inconvenience of constant intravenous infusion, the child was transferred to pump insulin delivery on its 53d-day of life. It was used the basal mode of delivery of insulin for each feed at a dose of 0.05 UN within 1 h (0.002 UN/kg per h), due to the fact that modern pumps are not suitable for the introduction of low doses of insulin with the help of bolus scheme. Glycaemia with the intravenous insulin is 20,9-16,4-2,9-12,6-10,1-1,5-4,6-9,7 mmol/l, the dynamics of glycemia on the background of continuous s.c. administration of insulin is – 13,5- 16,5- 10,4-11,0-9,5-7,5-8,5-6,5-4,0 mmol/l. On hospitalizing it was HbA1c −5.5% (2.9–4.2% – norm); C-peptide <0.1 ng/ml (0.9–4.0 – norm), after 1 month C-peptide is 1.93 ng/ml. In the 4 weeks was noted digestive disorders (lactase deficiency) insufficiency of the exocrine functions of the pancreas, which was corrected substitution therapy of pancreatic enzymes and in taking gidrolizirovanny mixture. Putting on weight for 2 months was 1.5 kg, glycaemia, it was returned to normal on the 7th week of life.

Conclusion: Insulin pump therapy effective in the treatment of neonatal diabetes.

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