Transient or Permanent?

One of the first questions parents ask is whether this will go away. There is a real answer, and it depends on the cause.

Neonatal diabetes divides into two broad courses.

• Transient neonatal diabetes appears in the first weeks of life, needs treatment for a period, and then settles. In the most common form, the diabetes lasts on average about three months, with remission generally expected by 18 months of age.
• Permanent neonatal diabetes does not go away. It needs treatment for life — although in many cases that treatment can be a tablet rather than injections.

There is an important caveat about the word transient. In this condition it does not mean cured. Diabetes returns later in possibly half or more of children who had the transient form, most often around puberty — in one series the average age of return was 14 years.

So a better way to think about transient neonatal diabetes is a condition that pauses rather than one that ends. Your child will need to stay connected to a doctor and be checked periodically, even during the years when nothing seems to be happening.

You cannot tell which form your baby has by waiting and watching, and waiting costs time that could be spent on the right treatment. The genetic result usually answers it, which is one more reason testing matters early.