title: KATP channel mutations in infants with permanent diabetes diagnosed after 6 months of life.
abstract: OBJECTIVE
  Mutations in the K(ATP)  channel genes are the commonest cause of permanent neonatal diabetes. Most patients obtain optimal glycemic control on sulfonylurea treatment. Genetic testing is currently recommended for all infants diagnosed before 6 months of age. We aimed to explore the prevalence of K(ATP)  channel diabetes in infants presenting between 6 and 12 months.
  
  
  METHODS
  The KCNJ11 and ABCC8 genes were sequenced in 115 infants with permanent diabetes diagnosed between 6 and 12 months and in 405 patients presenting before 6 months.
  
  
  RESULTS
  Mutations in either gene were identified in 197 patients diagnosed before 6 months (48.6%), three infants diagnosed between 6 and 9 months (4.2%) and none of those diagnosed after 9 months. Two patients diagnosed after 6 months were successfully transferred from insulin to sulfonylureas.
  
  
  CONCLUSIONS
  K(ATP)  channel mutations are an uncommon cause of diabetes in infants presenting after 6 months. However, given the potential clinical benefit from identifying a K(ATP)  channel mutation, we recommend that K(ATP)  mutation testing should be routinely extended to infants diagnosed up to 9 months.
authors: Institute of Biomedical and Clinical Science, Peninsula Medical School, University of Exeter, EX2 5DW Exeter, UK.
authors: Oscar
authors: O
authors: Rubio-Cabezas
authors: Sarah E
authors: SE
authors: Flanagan
authors: Annet
authors: A
authors: Damhuis
authors: Andrew T
authors: AT
authors: Hattersley
authors: Sian
authors: S
authors: Ellard
mesh_terms: D018528:ATP-Binding Cassette Transporters / Q000235:genetics*; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000235:genetics*; D005260:Female; D006801:Humans; D007223:Infant; D007328:Insulin / Q000627:therapeutic use; D054086:KATP Channels / Q000235:genetics*; D008297:Male; D024661:Potassium Channels, Inwardly Rectifying / Q000235:genetics*; D011955:Receptors, Drug / Q000235:genetics*; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D064233:Sulfonylurea Receptors; D000099161:Kcnj11 Channel
chemical_list: D018528:ATP-Binding Cassette Transporters; D007328:Insulin; D054086:KATP Channels; D024661:Potassium Channels, Inwardly Rectifying; D011955:Receptors, Drug; D013453:Sulfonylurea Compounds; D064233:Sulfonylurea Receptors; D000099161:Kcnj11 Channel