Background
Mother with poor type 1 diabetes compensation can cause severe complications for the baby - most severe - diabetic fetopathy. It presents as fetal macrosomia, hypertension and pre-eclampsia in the third trimester of gestation, sometimes even leading to intrauterine fetal death. Therefore, it is essential to maintain good metabolic control of the mother during pregnancy. The accelerated growth results from fetal hyperinsulinemia, when more glucose than necessary reach the fetus from the hyperglycemic mother. One of the most significant clinical signs is birth weight over 4000 g. This case report aims to assess diagnostic parameters between diabetic fetopathy and infant overfeeding.

Methods
The patient was studied under close observation in the ICU. Family history, physical examination, growth charts for preterm infants, blood tests and CGMS were used to determine the diagnosis.

Results
A 3 months old boy presented with an increased appetite, regurgitation and excess weight. The patient was born with an emergency  Caesarean section in the 32nd week of gestation with birth weight of 4300g. After birth he was hospitalized in NICU due to respiratory distress. Objective - increased subcutaneous fat, asymmetrical muscle tone. At 12 weeks postpartum the patient weigh 8260 g (+ > 3 SDS), height 66 cm (+ > 3 SDS) (See figure 1). Neuro-sonography, USG, urine and blood analysis showed no abnormalities. CGM 5 day average glycemia was 5.6 mmol/L and showed no episode of hypoglycemia. As it turned out, the mother was feeding him 960-1200 ml Friscolac infant formula in a 24 h period every 2.5 - 3 hour, including night time.

Conclusions
1. Diabetic fetopathy – the main risk factor of early onset baby overweight. 
2. It is essential to feed the infant correctly from the beginning to exclude the risk of obesity, important to educate the parents as well. 
3. In case of early infant obesity genetic causes and endocrinopathies must be excluded.

DIAGNOSTIC DIFFICULTIES - MOTHER WITH TYPE 1 DIABETES AND AN OBESE PRETERM INFANT: A CASE REPORT