title: Permanent neonatal diabetes mellitus.
abstract: BACKGROUND
  Neonatal diabetes is a rare cause of hyperglycemia, affecting 1: 500,000 births, with persistent hyperglycemia occurring in the first months of life lasting more than 2 weeks and requiring insulin. This condition in infants less than 6 months of age is considered as permanent neonatal diabetes mellitus.
  
  
  METHODS
  A rare case of permanent neonatal diabetes mellitus presented with intrauterine growth retardation (IUGR; birth weight: 1460 grams; female), hyperglycemia, glycosuria, and mild dehydration, a normal Apgar score of 8 and 9 at 1 and 5 minutes, respectively. The parents, of consanguineous union, had no prior history of diabetes mellitus. Of their 4 children, the first child had a diagnosis similar to the patient (their last child). The patient was initially started on continuous infusion of insulin, and then switched to regular insulin subcutaneously, but response was sub-optimal. She was started on neutral protamine Hagedorn, following which her condition improved. She was discharged on neutral protamine Hagedorn with regular follow-up.
  
  
  CONCLUSIONS
  In view of widespread consanguinity in Saudi Arabia it appears prudent and pertinent to suspect permanent neonatal diabetes mellitus following diagnosis of hyperglycemia in small-for-age infants, especially those with positive family history of diabetes. Close blood glucose monitoring is essential as long as hyperglycemia persists. Prolong follow-up is imperative.
authors.affiliation: Department of Neonatology, King Fahad Medical City Riyadh, Saudi Arabia.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al-Matary
authors.forename: Mushtaq
authors.initials: M
authors.lastname: Hussain
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nahari
authors.forename: Jaffar
authors.initials: J
authors.lastname: Ali
keywords: consanguinity; diabetes; hyperglycemia; insulin; neonatal; neutral protamine Hagedorn