Neonatal diabetes is a rare form of diabetes that is usually diagnosed in children under 6 months of age.
This early occurring type of diabetes is caused by one of a number of genetic mutations and is therefore described as a monogenic form of diabetes.
Neonatal diabetes is treatable and may or may not require insulin so a diagnosis by genetic testing is recommended.
Types of neonatal diabetes
There are two main types of neonatal diabetes:
- Transient Neonatal Diabetes Mellitus
- Permanent Neonatal Diabetes Mellitus
Transient neonatal diabetes is so called because it usually disappears within a year of birth but can come back again typically during adolescence
Permanent neonatal diabetes, once diagnosed, stays for the rest of life.
How common is neonatal diabetes?
Neonatal diabetes is very rare, occurring in around 1 in 300,000 to 1 in 400,000 births
Out of the two types of neonatal diabetes, the transient type is slightly more common affecting 50-60% of cases of neonatal diabetes. 
Symptoms and diagnosis
Presence of diabetes mellitus can be diagnosed with a blood glucose test. A diagnosis of diabetes before 6 months should suggest neonatal diabetes, as opposed to type 1 diabetes
In some cases, neonatal diabetes may be diagnosed after 6 months however.
Genetic testing is advised for children diagnosed with diabetes under the age of 9 months to asses which form of diabetes is present and to guide the best form of treatment. 
Neonatal diabetes will usually either be treated with a drug called glibenclamide or with insulin.
Around 50% of people with neonatal diabetes can be treated with glibenclamide, a drug which causes the pancreas to release more insulin. Glibenclamide is in a class of diabetes drugs called sulfonylureas If glibenclamide is not effective enough, insulin will need to be taken.
If neonatal diabetes is transient, it won’t require treatment during the years in which it is resolved. However, the condition should be monitored for reappearance of diabetes in adolescence and later years.
A number of health complications can occur in people with neonatal diabetes, depending on which gene is affected. The following complications are relatively common in children with neonatal diabetes:
- Developmental delay such as muscle weakness and learning disabilities
- Diabetic ketoacidosis
- Low birth weight
- Muscle weakness
- Macroglossia – a larger than normal tongue
Treatment with glibenclamide has been shown to help reduce the effects of developmental delay.
Neonatal diabetes is genetic disorder for which, unfortunately, there is no known prevention.