The Infant Of A Diabetic Mother (IDM)
Description Diagnostic criteria General and supportive measures Medicine treatment Referral DESCRIPTION Infants born to a mother with established or newly diagnosed diabetes mellitus. The foetus will be exposed to high levels of insulin in utero if maternal glycaemic control is not achieved, with foetal pancreatic hypertrophy as an adaptive measure. The infant of a diabetic mother is at increased
Description
Diagnostic criteria
General and supportive measures
Medicine treatment
Referral
DESCRIPTION
Infants born to a mother with established or newly diagnosed diabetes mellitus. The foetus will be exposed to high levels of insulin in utero if maternal glycaemic control is not achieved, with foetal pancreatic hypertrophy as an adaptive measure. The infant of a diabetic mother is at increased risk of morbidity and mortality.
DIAGNOSTIC CRITERIA
IDM babies may show signs related to insulin and/or glucose toxicity, as well as complications of the withdrawal of insulin. As maternal diabetes may be undiagnosed, the condition should be suspected in infants with the following:
- Hypoglycaemia
- Polycythaemia
- Hyperbilirubinaemia
- Respiratory distress syndrome.
- Hypertrophic cardiomyopathy.
- Congenital malformations, especially cardiac malformations and sacral agenesis.
- Macrosomia, which predisposes to birth injuries.
GENERAL AND SUPPORTIVE MEASURES
- Strict glucose monitoring: after birth, at 30 minutes, 1 hour, 2 hours and before each feed for all LGA babies or a confirmed IDM.
MEDICINE TREATMENT
REFERRAL
- Severe, persistent hypoglycaemia requiring more than 12.5% intravenous dextrose to maintain normal glucose levels.
- Congenital malformations or birth injuries requiring specialist management.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 19: Prematurity And Neonatal Conditions, 19.7 Metabolic, 19.7.3 The Infant Of A Diabetic Mother (IDM)