What the Pancreas Is and Isn't Doing
Reviewed by CDE Mehandi Sharma · Updated
Understanding what is actually happening inside your baby makes the treatment decisions ahead much easier to follow.
The pancreas is an organ behind the stomach. Inside it are beta cells, whose only job is to release insulin when blood sugar rises — after a feed, for example. Insulin then lets sugar move from the blood into the body's cells, where it becomes energy and growth.
In most forms of neonatal diabetes, those beta cells are present and healthy. They are full of insulin. The problem is the switch that tells them when to release it.
Think of a door held open by a spring. Normally, when sugar arrives in the blood, the beta cell closes that door, which triggers insulin release. In the commonest genetic causes of neonatal diabetes, the door is stuck open. Sugar arrives, the signal never gets through, and the insulin stays locked inside.
This is why the condition responds to a tablet in so many children. Certain medicines close that door directly, from a different angle, bypassing the faulty mechanism entirely. The insulin was there all along.
Not every form works this way. In some, the beta cells themselves are damaged or too few, and insulin has to be supplied from outside. Which situation applies to your baby is exactly what the genetic test establishes.
The mechanism of the stuck door is explained further in the potassium channel explained.