A Case of Mauriac Syndrome Caused by Social Inequities in Healthcare: A Call to Action

Abstract

Presented here is a case of Mauriac syndrome with persistent lactatemia in a 21-year-old female with a history of poor glycaemic control. Mauriac syndrome is a severe complication of Type 1 diabetes mellitus (T1DM) characterised by glycogen accumulation in the liver leading to hepatomegaly. Mauriac syndrome is considered to be a very rare and preventable complication due to better treatment options for T1DM. Most cases of Mauriac syndrome today involve children and adolescents who face socioeconomic inequities that prevent them from accessing adequate healthcare and affording insulin, as is the case with this patient. The combination of low health literacy, insulin unaffordability, and difficulty accessing healthcare for her chronic condition all contributed to her poorly controlled T1DM. It has been well established that insulin has become difficult to afford for insulin-dependent patients. An alarming one out of four insulin-dependent patients have rationed their doses due to the high cost of insulin. Progress has been made to cap the price of insulin at 35 USD to prevent price-gouging for certain populations in the USA but not all. Young patients with poorly controlled T1DM and low socioeconomic status require higher levels of social support and public health intervention to prevent serious complications of T1DM such as Mauriac syndrome.