5 min readNew DelhiAug 25, 2026 09:26 AM IST
Neonatal diabetes is a rare form of diabetes that is diagnosed during the first months of life. Unlike the forms of diabetes that are more commonly discussed in older children and adults, its course can be quite different, and in some babies, high blood sugar does not necessarily continue throughout life.
This can make the condition particularly difficult for parents to understand. A baby may require treatment for high blood sugar early in life, only for the diabetes to improve or go into remission later. In other cases, however, diabetes can return after a period without symptoms, raising questions about what determines its course.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
So, what causes diabetes to develop so early in life, and why does it sometimes appear to disappear? We spoke to an expert to understand what happens to insulin production in these babies, which forms of neonatal diabetes are more likely to go into remission, and what families should know about the possibility of diabetes returning.
What is neonatal diabetes and how does it differ from other types?
Kanikka Malhotra, Consultant Dietician and Diabetes Educator, tells indianexpress.com, “Neonatal diabetes is a rare condition that shows up within the first six months of life. Unlike other forms of diabetes, it is not caused by the immune system or lifestyle factors but by a single gene fault present from birth, one that affects how beta cells sense glucose and release insulin. This is the key difference. Type 1 diabetes develops when the immune system slowly destroys beta cells, and type 2 develops when the body gradually resists insulin’s effect.”
She continues, “Neonatal diabetes skips all of that and starts with faulty wiring in the insulin system itself. The genes most often involved, KCNJ11 and ABCC8, control tiny channels that trigger insulin release. Think of it like a switch wired wrong from day one, not a bulb that wears out over time. Because the cause is a specific gene, identifying which one is involved actually helps doctors decide the right treatment early on.”
Why can neonatal diabetes go into remission?
Certain genetic forms, Malhotra says, particularly those linked to chromosome 6 abnormalities, follow a distinctive pattern where beta cells regain enough function over months as the pancreas matures, allowing insulin production to normalise temporarily. This is called transient neonatal diabetes, and it affects close to half of all cases.
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“The immature beta cells in early infancy struggle to regulate insulin release properly, but as pancreatic development completes, this control improves. It resembles a new employee who initially struggles with a task, then becomes capable once fully trained. The genetic defect itself does not disappear, but its functional impact temporarily resolves. Babies with this pattern often come off insulin within months, sometimes staying medication-free for years. However, this remission is closely tied to the specific gene involved, making early genetic testing valuable for predicting which infants are more likely to follow this reversible course,” explains the expert.
Can neonatal diabetes return after remission?
Quick Quiz
See if you can answer this:
Can transient neonatal diabetes return after a period of remission?
A. No, remission means the condition is permanently cured.
B. Yes, it can relapse later, often during adolescence or early adulthood or when the body faces increased metabolic stress.
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C. Only if the child stops following a special diet.
D. Only after another infection occurs during childhood.
Reveal the answer
✅ Correct answer: B
According to Malhotra, transient neonatal diabetes can return after a period of remission, commonly during adolescence or early adulthood. Puberty, significant weight gain, pregnancy or physical stress may place additional demands on pancreatic beta cells and trigger a relapse. The underlying genetic predisposition remains even when symptoms have disappeared.
Parents should be alert to symptoms such as increased thirst, frequent urination, unexplained weight loss or fatigue, particularly during periods of rapid growth or other major changes. Periodic glucose or HbA1c monitoring may be recommended even when the child appears healthy. Genetic counselling can also help families understand the potential implications for siblings and future pregnancies.
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DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.