Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea

Eman Ahmad Alsafi; Ihab Abdulhamed Ahmad; Abdulmoein Eid AL-Agha

doi:doi:10.11648/j.ajbls.20150304.13

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Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea

Eman Ahmad Alsafi, Ihab Abdulhamed Ahmad, Abdulmoein Eid AL-Agha

Published in American Journal of Biomedical and Life Sciences (Volume 3, Issue 4)

Received: 12 April 2014 Accepted: 28 July 2014 Published: 9 July 2015

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Abstract

Patients with permanent neonatal diabetes usually present within the first three months of life and need insulin treatment. In most, the cause is unknown. Because ATP-sensitive potassium (KATP) channels mediate glucose-stimulated insulin secretion from the pancreatic beta cells, activating mutations in the gene encoding the Kir6.2 subunit of this channel (KCNJ11) cause neonatal diabetes. Genotyping identifies the exact molecular etiology of early onset insulin requiring diabetes and has the potential to alter the management of the patient, who would otherwise be insulin dependent for life. Method: We identified a 6 year-old child who presented at 3 months of age with diabetic ketoacidosis. Blood samples for molecular genetic analysis were done. Results: The patient was diagnosed as a heterozygous for a missense mutation in the (KCNJ11) gene, for which she switched to sulphonylurea with a dose of 0.05 mg/kg/day. Conclusion: the need for medical practitioners to consider molecular testing for all patients who present with diabetes below 6 months of age as this will facilitate accurate diagnosis and appropriate therapy.

Published in	American Journal of Biomedical and Life Sciences (Volume 3, Issue 4)
DOI	10.11648/j.ajbls.20150304.13
Page(s)	84-86
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Genetic Analysis, Neonatal Diabetes, Sulphonylurea

References

[1]	Karl Ernst von Mühlendah, M.D., and Heiner Herkenhoff, M.D. Long-Term Course of Neonatal Diabetes .N Engl J Med 1995; 333:704-708 DOI: 10.1056/NEJM199509143331105
[2]	Gloyn AL, Pearson ER, Antcliff JF, Proks P, Bruining GJ, Slingerland AS, Howard N, Srinivasan S, Silva JM, Molnes J, Edghill EL, Frayling TM, Temple IK, Mackay D, Shield JP, Sumnik Z, van Rhijn A, Wales JK, Clark P, Gorman S, Aisenberg J, Ellard S, Njølstad PR, Ashcroft FM, Hattersley AT. Activating mutations in the gene encoding the ATP-sensitive potassium-channel subunit Kir6.2 and permanent neonatal diabetes. N Engl J Med. 2004;350(18):1838.
[3]	Gloyn AL, Cummings EA, Edghill EL, Harries LW, Scott R, Costa T, Temple IK, Hattersley AT, Ellard S. Permanent neonatal diabetes due to paternal germline mosaicism for an activating mutation of the KCNJ11 Gene encoding the Kir6.2 subunit of the beta-cell potassium adenosine triphosphate channel. J Clin Endocrinol Metab. 2004;89(8):3932
[4]	Pearson ER, Flechtner I, Njølstad PR, Malecki MT, Flanagan SE, Larkin B, Ashcroft FM, Klimes I, Codner E, Iotova V, Slingerland AS, Shield J, Robert JJ, Holst JJ, Clark PM, Ellard S, Søvik O, Polak M, Hattersley AT, Neonatal Diabetes International Collaborative Group . Switching from insulin to oral sulfonylureas in patients with diabetes due to Kir6.2 mutations.N Engl J Med. 2006;355(5):467.
[5]	Landau Z, Wainstein J, Hanukoglu A, Tuval M, Lavie J, Glaser B. Sulfonylurea-responsive diabetes in childhood. J Pediatr. 2007;150(5):553
[6]	Zung A, Glaser B, Nimri R, Zadik Z. Glibenclamide treatment in permanent neonatal diabetes mellitus due to an activating mutation in Kir6.2 . J Clin Endocrinol Metab. 2004 Nov;89(11):5504-7
[7]	Hattersley AT, Ashcroft FM. Activating mutations in Kir6.2 and neonatal diabetes: new clinical syndromes, new scientific insights, and new therapy. Diabetes, VOL. 54, september 2005. ADA.
[8]	Anna L. Gloyn, D.Phil., Ewan R. Pearson, M.R.C.P., Jennifer F. Antcliff, B.Sc., Peter Proks, D.Phil., G. Jan Bruining, M.D., Annabelle S. Slingerland, M.D., Neville Howard, M.D., F.R.A.C.P., Shubha Srinivasan, M.B., B.S., M.R.C.P., José M.C.L. Silva, M.D., Janne Molnes, M.Sc., Emma L. Edghill, M.Sc., Timothy M. Frayling, Ph.D., I. Karen Temple, F.R.C.P., Deborah Mackay, Ph.D., Julian P.H. Shield, M.D., F.R.C.P.C.H., Zdenek Sumnik, M.D., Adrian van Rhijn, M.D., Jerry K.H. Wales, D.M., F.R.C.P.C.H., Penelope Clark, Ph.D., F. R. C. Path., Shaun Gorman, M.R.C.P., Javier Aisenberg, M.D., Sian Ellard, Ph.D., M. R. C. Path., Pål R. Njølstad, M.D., Ph.D., Frances M. Ashcroft, Ph.D., and Andrew T. Hattersley, D.M., F.R.C.P. Activating Mutations in the Gene Encoding the ATP-Sensitive Potassium-Channel Subunit Kir6.2 and Permanent Neonatal Diabetes .N Engl J Med 2004;350:1838-49.
[9]	Rica I, Luuriaga C, Peres de Nanclares G, Estalella I, Aragones A, et al.The majority of cases of neonatal diabetes in Spain can be explained by known genetic abnormalities. DIABETIC Medicine 2007; 24:707-13.
[10]	10.Slingerland AS, Nuboer R, Hadders-Algra M et al (2006) Improved motor development and good longterm glycaemic control with sulfonylurea treatment in a patient with the syndrome of intermediate developmental delay, early-onset generalised epilepsy and neonatal diabetes associated with the V59M mutation in the KCNJ11 gene. Diabetologia 49: 2559–63
[11]	Edghill et al, Insulin Mutation Screening in 1,044 Patients With Diabetes .Mutations in the INS Gene Are a Common Cause of Neonatal Diabetes but a Rare Cause of Diabetes Diagnosed in Childhood or Adulthood. DIABETES, VOL. 57, APRIL 2008
[12]	Sagen JV, Ræder H, Hathout E et al (2004) Permanent neonatal diabetes due to mutation in KCNJ11 encoding Kir6.2: patient characteristics and initial response to sulfonylurea therapy. Diabetes 53: 2713–18

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APA Style

Eman Ahmad Alsafi, Ihab Abdulhamed Ahmad, Abdulmoein Eid AL-Agha. (2015). Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea. American Journal of Biomedical and Life Sciences, 3(4), 84-86. https://doi.org/10.11648/j.ajbls.20150304.13

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ACS Style

Eman Ahmad Alsafi; Ihab Abdulhamed Ahmad; Abdulmoein Eid AL-Agha. Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea. Am. J. Biomed. Life Sci. 2015, 3(4), 84-86. doi: 10.11648/j.ajbls.20150304.13

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AMA Style

Eman Ahmad Alsafi, Ihab Abdulhamed Ahmad, Abdulmoein Eid AL-Agha. Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea. Am J Biomed Life Sci. 2015;3(4):84-86. doi: 10.11648/j.ajbls.20150304.13

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@article{10.11648/j.ajbls.20150304.13,
  author = {Eman Ahmad Alsafi and Ihab Abdulhamed Ahmad and Abdulmoein Eid AL-Agha},
  title = {Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea},
  journal = {American Journal of Biomedical and Life Sciences},
  volume = {3},
  number = {4},
  pages = {84-86},
  doi = {10.11648/j.ajbls.20150304.13},
  url = {https://doi.org/10.11648/j.ajbls.20150304.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbls.20150304.13},
  abstract = {Patients with permanent neonatal diabetes usually present within the first three months of life and need insulin treatment. In most, the cause is unknown. Because ATP-sensitive potassium (KATP) channels mediate glucose-stimulated insulin secretion from the pancreatic beta cells, activating mutations in the gene encoding the Kir6.2 subunit of this channel (KCNJ11) cause neonatal diabetes. Genotyping identifies the exact molecular etiology of early onset insulin requiring diabetes and has the potential to alter the management of the patient, who would otherwise be insulin dependent for life. Method: We identified a 6 year-old child who presented at 3 months of age with diabetic ketoacidosis. Blood samples for molecular genetic analysis were done. Results: The patient was diagnosed as a heterozygous for a missense mutation in the (KCNJ11) gene, for which she switched to sulphonylurea with a dose of 0.05 mg/kg/day. Conclusion: the need for medical practitioners to consider molecular testing for all patients who present with diabetes below 6 months of age as this will facilitate accurate diagnosis and appropriate therapy.},
 year = {2015}
}

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TY  - JOUR
T1  - Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea
AU  - Eman Ahmad Alsafi
AU  - Ihab Abdulhamed Ahmad
AU  - Abdulmoein Eid AL-Agha
Y1  - 2015/07/09
PY  - 2015
N1  - https://doi.org/10.11648/j.ajbls.20150304.13
DO  - 10.11648/j.ajbls.20150304.13
T2  - American Journal of Biomedical and Life Sciences
JF  - American Journal of Biomedical and Life Sciences
JO  - American Journal of Biomedical and Life Sciences
SP  - 84
EP  - 86
PB  - Science Publishing Group
SN  - 2330-880X
UR  - https://doi.org/10.11648/j.ajbls.20150304.13
AB  - Patients with permanent neonatal diabetes usually present within the first three months of life and need insulin treatment. In most, the cause is unknown. Because ATP-sensitive potassium (KATP) channels mediate glucose-stimulated insulin secretion from the pancreatic beta cells, activating mutations in the gene encoding the Kir6.2 subunit of this channel (KCNJ11) cause neonatal diabetes. Genotyping identifies the exact molecular etiology of early onset insulin requiring diabetes and has the potential to alter the management of the patient, who would otherwise be insulin dependent for life. Method: We identified a 6 year-old child who presented at 3 months of age with diabetic ketoacidosis. Blood samples for molecular genetic analysis were done. Results: The patient was diagnosed as a heterozygous for a missense mutation in the (KCNJ11) gene, for which she switched to sulphonylurea with a dose of 0.05 mg/kg/day. Conclusion: the need for medical practitioners to consider molecular testing for all patients who present with diabetes below 6 months of age as this will facilitate accurate diagnosis and appropriate therapy.
VL  - 3
IS  - 4
ER  -

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Author Information

Eman Ahmad Alsafi

Department of Pediatrics, Elsafi, Al-Agha and Ahmad, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
Ihab Abdulhamed Ahmad

Department of Pediatrics, Elsafi, Al-Agha and Ahmad, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
Abdulmoein Eid AL-Agha

Department of Pediatrics, Elsafi, Al-Agha and Ahmad, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia

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APA Style

Eman Ahmad Alsafi, Ihab Abdulhamed Ahmad, Abdulmoein Eid AL-Agha. (2015). Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea. American Journal of Biomedical and Life Sciences, 3(4), 84-86. https://doi.org/10.11648/j.ajbls.20150304.13

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ACS Style

Eman Ahmad Alsafi; Ihab Abdulhamed Ahmad; Abdulmoein Eid AL-Agha. Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea. Am. J. Biomed. Life Sci. 2015, 3(4), 84-86. doi: 10.11648/j.ajbls.20150304.13

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AMA Style

Eman Ahmad Alsafi, Ihab Abdulhamed Ahmad, Abdulmoein Eid AL-Agha. Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea. Am J Biomed Life Sci. 2015;3(4):84-86. doi: 10.11648/j.ajbls.20150304.13

Copy | Download

@article{10.11648/j.ajbls.20150304.13,
  author = {Eman Ahmad Alsafi and Ihab Abdulhamed Ahmad and Abdulmoein Eid AL-Agha},
  title = {Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea},
  journal = {American Journal of Biomedical and Life Sciences},
  volume = {3},
  number = {4},
  pages = {84-86},
  doi = {10.11648/j.ajbls.20150304.13},
  url = {https://doi.org/10.11648/j.ajbls.20150304.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbls.20150304.13},
  abstract = {Patients with permanent neonatal diabetes usually present within the first three months of life and need insulin treatment. In most, the cause is unknown. Because ATP-sensitive potassium (KATP) channels mediate glucose-stimulated insulin secretion from the pancreatic beta cells, activating mutations in the gene encoding the Kir6.2 subunit of this channel (KCNJ11) cause neonatal diabetes. Genotyping identifies the exact molecular etiology of early onset insulin requiring diabetes and has the potential to alter the management of the patient, who would otherwise be insulin dependent for life. Method: We identified a 6 year-old child who presented at 3 months of age with diabetic ketoacidosis. Blood samples for molecular genetic analysis were done. Results: The patient was diagnosed as a heterozygous for a missense mutation in the (KCNJ11) gene, for which she switched to sulphonylurea with a dose of 0.05 mg/kg/day. Conclusion: the need for medical practitioners to consider molecular testing for all patients who present with diabetes below 6 months of age as this will facilitate accurate diagnosis and appropriate therapy.},
 year = {2015}
}

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TY  - JOUR
T1  - Importance of genetic testing in neonatal diabetes and use of sulphonylureaImportance of genetic testing in neonatal diabetes and use of sulphonylurea
AU  - Eman Ahmad Alsafi
AU  - Ihab Abdulhamed Ahmad
AU  - Abdulmoein Eid AL-Agha
Y1  - 2015/07/09
PY  - 2015
N1  - https://doi.org/10.11648/j.ajbls.20150304.13
DO  - 10.11648/j.ajbls.20150304.13
T2  - American Journal of Biomedical and Life Sciences
JF  - American Journal of Biomedical and Life Sciences
JO  - American Journal of Biomedical and Life Sciences
SP  - 84
EP  - 86
PB  - Science Publishing Group
SN  - 2330-880X
UR  - https://doi.org/10.11648/j.ajbls.20150304.13
AB  - Patients with permanent neonatal diabetes usually present within the first three months of life and need insulin treatment. In most, the cause is unknown. Because ATP-sensitive potassium (KATP) channels mediate glucose-stimulated insulin secretion from the pancreatic beta cells, activating mutations in the gene encoding the Kir6.2 subunit of this channel (KCNJ11) cause neonatal diabetes. Genotyping identifies the exact molecular etiology of early onset insulin requiring diabetes and has the potential to alter the management of the patient, who would otherwise be insulin dependent for life. Method: We identified a 6 year-old child who presented at 3 months of age with diabetic ketoacidosis. Blood samples for molecular genetic analysis were done. Results: The patient was diagnosed as a heterozygous for a missense mutation in the (KCNJ11) gene, for which she switched to sulphonylurea with a dose of 0.05 mg/kg/day. Conclusion: the need for medical practitioners to consider molecular testing for all patients who present with diabetes below 6 months of age as this will facilitate accurate diagnosis and appropriate therapy.
VL  - 3
IS  - 4
ER  -

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