Diabetes is a chronic disorder of metabolism
characterized by a partial or complete deficiency
of the hormone insulin. It is the most common
metabolic disease. Diabetes mellitus affect
approximately 15.7 million persons in the United
States. DM in children can occur at any age but
has a peak incidence between ages 10 and 15
years, with 75% diagnosed before 18 years of
age. The incidence in boys is slightly higher than
in girls. Maternal diabetes mellitus leads various
health problems in infants.
It is defined as a baby who is born to a
mother with diabetes that causes baby
at risk of problems.
1. Gestational Diabetes Mellitus – Mother who are
detected diabetes mellitus first time during the
2. Pre-existing (pre-pregnant) Diabetes Mellitus
– Mothers who have diabetes approximately mellitus
before pregnancy or conceiving.
It is estimated that childhood diabetes accounts
for around 5% of total population of diabetes. In
India there are about 4,00,000 infants and
children with this disease.
CLINICAL FEATURES or EFFECTS
OF DIABETES MELLITUS
The infant of a diabetic mother is larger and
Body of neonates covered with vernix caseosa.
Neonates may develop hypoglycemia if mother is
having severe hypoglycemia, sometimes it is
required to provide glucose by intravenously.
Birth injury can occur due to large size of baby
during passage of fetus from birth canal.
1. Before baby is born
A. Ultrasound :- It is done to detect the size of baby. It would
B. Lung maturity test :- In this take sample of amniotic fluid
to detect lung surfactant ratio.
2. After Birth
A. Check Baby’s blood sugar level :- It check within first hour
or two hours after birth & rechecked regularly until it is
This test would show hypoglycemia.
B. Check bilirubin level :- This test would show increased
bilirubin level (>5 mg/dl).
Normal bilirubin level in infant is below 5mg/dl.
C. Check the baby for sign of trouble with heart &
D. Echocardiogram :- It is a imaging test done to
check the size of baby’s heart.
• Respiratory distress syndrome
• Hypocalcemia & Hyperbilirubinemia
• Congenital Malformation of brain,
gastrointestinal, urinary system and spinal cord
• Pulmonary hypertension & polycythemia can
• Birth asphyxia may occur.
• Treatment of birth injury as early as possible.
• Oxygen supply to neonates if respiratory distress
• Provide glucose to prevent hypoglycemia.
• Continue monitoring of blood glucose level by a
umbilical catheter or by a needle.
• Start oral feeding as early as possible.
• Continue close monitoring of baby and treat the
• It is based on pre-natal care.
• Regular checkup of pregnant mother.
• Regular monitoring of blood glucose.
• Provide the insulin therapy.
• Provide education and counselling to mothers.
• Conduction of delivery at well equipped hospital with all
modern neonatal intensive care services.
• Provision of adequate antenatal care.
• Educate mother about breastfeeding and care of the baby.
• Early detection and immediate treatment plan should
• Monitor serum bilirubin level.
• Maintain thermal environment.
• Provide IV glucose according to need.
• Monitor glucose level 3 to 4 hours level not
• Initiating and maintaining respiration.
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