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Le Bourgeois F, Beltrand J, Baz B, Julla JB, Riveline JP, Simon A, Flechtner I, Ait Djoudi M, Fauret-Amsellem AL, Vial Y, Scharfmann R, Sommet J, Boudou P, Cavé H, Polak M, Gautier JF, Busiah K. Long-term Metabolic and Socioeducational Outcomes of Transient Neonatal Diabetes: A Longitudinal and Cross-sectional Study. Diabetes Care 2020; 43:1191-1199. [PMID: 32273272 DOI: 10.2337/dc19-0324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 03/05/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Transient neonatal diabetes mellitus (TNDM) occurs during the 1st year of life and remits during childhood. We investigated glucose metabolism and socioeducational outcomes in adults. RESEARCH DESIGN AND METHODS We included 27 participants with a history of TNDM currently with (n = 24) or without (n = 3) relapse of diabetes and 16 non-TNDM relatives known to be carriers of causal genetic defects and currently with (n = 9) or without (n = 7) diabetes. Insulin sensitivity and secretion were assessed by hyperinsulinemic-euglycemic clamp and arginine-stimulation testing in a subset of 8 TNDM participants and 7 relatives carrying genetic abnormalities, with and without diabetes, compared with 17 unrelated control subjects without diabetes. RESULTS In TNDM participants, age at relapse correlated positively with age at puberty (P = 0.019). The mean insulin secretion rate and acute insulin response to arginine were significantly lower in TNDM participants and relatives of participants with diabetes than in control subjects (median 4.7 [interquartile range 3.7-5.7] vs. 13.4 [11.8-16.1] pmol/kg/min, P < 0.0001; and 84.4 [33.0-178.8] vs. 399.6 [222.9-514.9] µIU/mL, P = 0.0011), but were not different between participants without diabetes (12.7 [10.4-14.3] pmol/kg/min and 396.3 [303.3-559.3] µIU/mL, respectively) and control subjects. Socioeducational attainment was lower in TNDM participants than in the general population, regardless of diabetes duration. CONCLUSIONS Relapse of diabetes occurred earlier in TNDM participants compared with relatives and was associated with puberty. Both groups had decreased educational attainment, and those with diabetes had lower insulin secretion capacity; however, there was no difference in insulin resistance in adulthood. These forms of diabetes should be included in maturity-onset diabetes of the young testing panels, and relatives of TNDM patients should be screened for underlying defects, as they may be treated with drugs other than insulin.
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Affiliation(s)
- Fleur Le Bourgeois
- Department of Pediatric Critical Care and Intensive Care, Robert Debré Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jacques Beltrand
- Department of Pediatric Endocrinology, Gynecology, and Diabetology, Necker-Enfants Malades Teaching Hospital, Assistance Publique-Hôpitaux de Paris, IMAGINE Institute Affiliate, Paris, France.,INSERM Unité Médicale de Recherche UMR 1016, Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Baz Baz
- Department of Diabetes and Endocrinology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Paris, France
| | - Jean-Baptiste Julla
- INSERM UMRS 1138, Centre de Recherches des Cordeliers, Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Jean-Pierre Riveline
- Department of Diabetes and Endocrinology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Paris, France.,INSERM UMRS 1138, Centre de Recherches des Cordeliers, Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Albane Simon
- Department of Pediatrics, André Mignot Hospital, Le Chesnay, France
| | - Isabelle Flechtner
- Department of Pediatric Endocrinology, Gynecology, and Diabetology, Necker-Enfants Malades Teaching Hospital, Assistance Publique-Hôpitaux de Paris, IMAGINE Institute Affiliate, Paris, France
| | - Malek Ait Djoudi
- Centre Universitaire du Diabète et ses Complications, Hôpital Lariboisière, Clinical Investigation Center, INSERM-CIC 9504, Paris, France
| | - Anne-Laure Fauret-Amsellem
- Department of Genetics, Robert Debré Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Yoann Vial
- Department of Genetics, Robert Debré Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Raphael Scharfmann
- INSERM Unité Médicale de Recherche UMR 1016, Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Julie Sommet
- Department of Pediatric Critical Care and Intensive Care, Robert Debré Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Boudou
- Unit of Hormonal Biology, Department of Biochemistry, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Hélène Cavé
- Department of Genetics, Robert Debré Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Michel Polak
- Department of Pediatric Endocrinology, Gynecology, and Diabetology, Necker-Enfants Malades Teaching Hospital, Assistance Publique-Hôpitaux de Paris, IMAGINE Institute Affiliate, Paris, France.,INSERM Unité Médicale de Recherche UMR 1016, Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Jean-François Gautier
- Department of Diabetes and Endocrinology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Paris, France .,INSERM UMRS 1138, Centre de Recherches des Cordeliers, Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Kanetee Busiah
- Department of Pediatric Endocrinology, Gynecology, and Diabetology, Necker-Enfants Malades Teaching Hospital, Assistance Publique-Hôpitaux de Paris, IMAGINE Institute Affiliate, Paris, France.,Pediatric Endocrinology, Diabetology and Obesity Unit, Lausanne University Hospital, Lausanne University, Lausanne, Switzerland
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