Diabetes in young – unusual case presentation

Kumar, K.V.S. Hari; Priya, Sai; Shaikh, Altamash; Prusty, Pitambar

doi:10.1515/jpem.2011.253

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…[4][5][6] Untreated diabetes will lead to worsening neuropathy. The Oslo study, a random, prospective trial that investigated the effect of long term glycemic control on motor and sensory nerve conduction suggested that a 1% rise in A 1C values correlated with 1.3 m/sec slowing of conduction in nerves.…”

Section: Discussionmentioning

confidence: 99%

Unusual initial presentation of type 1 diabetes mellitus

Abbasi

B²

2014

Int J Contemp Pediatr

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A 21 year-old Caucasian girl presented to her pediatrician with a three day history of pre-tibial numbness extending from her knee to her ankle. She denied numbness in this area or elsewhere on her body before. She denied any traumatic event. She noted a 70-pound unintentional weight loss over the past 9 months. She described the numbness as "pins and needles". She denied pain, muscle weakness, difficulty walking, altered mental status, polydipsia, polyuria, and polyphagia. She denied tobacco, alcohol, or drug use. Her past surgical history was unremarkable. Her family history was significant for sarcoidosis, thyroid cancer, and T1DM.Physical exam revealed an afebrile, well appearing girl in no acute distress. Her blood pressure was 126/80, weight 158 pounds, and height 5'6. Her cardiovascular, pulmonary, and abdominal exams were unremarkable. Her neurologic exam was remarkable for pretibial peripheral sensory neuropathy. Testing sharp and dull palpation reproduced feeling "pins and needles" consistent with the area of numbness. Cranial nerves, deep tendon reflexes, muscle tone, and other neurological parameters were normal.A magnetic resonance image of the brain and knee with basic screening labs including vitamin B12/folate levels, sedimentation rate, thyroid stimulating hormone, T3, and T4 were ordered. The hepatic and thyroid panels were within normal limits. Her labs were significant for a mild hyponatremia (132 mmol/L) and hypochloremia (94 mmol/L), and glucose of 535 mg/dL. On the basis of these findings, the diagnosis was confirmed. DISCUSSIONBased on her family history for autoimmune disorders, we considered the possibilities of multiple sclerosis and thyroid cancer, but her laboratory suggested diabetes. The patient was admitted to the hospital and managed with IV fluid hydration, electrolyte balance, glucose control, and diabetic education. Endocrinology confirmed her peripheral neuropathy was related to her newly diagnosed diabetes.Type 1 diabetes mellitus is one of the most common chronic, autoimmune diseases in childhood in the United States, with the incidence in non-Hispanic white children and adolescents as 23.6 per 100000 per year, and the prevalence is 2.0 per 1000.1 The criteria for diagnosis ABSTRACTType 1 Diabetes Mellitus (T1DM) is an autoimmune destruction of B-islet cells. T1DM usually presents in children less than 15 years old with polyuria, polydipsia, polyphagia, and weight loss. Complications include diabetic ketoacidosis, hypoglycemia, retinopathy, neuropathy, nephropathy, and atherosclerosis. We present an unusual initial presentation for T1DM in a 21-year old Caucasian girl with pretibial numbness for three days.

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Section: Discussionmentioning

confidence: 99%

Unusual initial presentation of type 1 diabetes mellitus

Abbasi

B²

2014

Int J Contemp Pediatr

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“…The adjudication of patients into either T1DM or T2DM is often difficult in lean, young individuals with DM. 9 The factors that aid in the differentiation are the β-cell function, IR, Management of Type 2 Diabetes and Associated Vascular Complications Hari Kumar et al…”

Section: Etiopathogenesismentioning

confidence: 99%

“…The adjudication of patients into either T1DM or T2DM is often difficult in lean, young individuals with DM. 9 The factors that aid in the differentiation are the β-cell function, IR, and autoimmune antibody markers. We studied the etiopathogenetic markers in nonobese patients, aged younger than 35 years with DM.…”

Section: Etiopathogenesismentioning

confidence: 99%

Novel Approaches in the Management of Type 2 Diabetes and Associated Vascular Complications

Kumar

2021

ANAMS

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Diabetes mellitus (DM) is growing in pandemic proportion and affects the affluent and developing nations equally. India has the dubious distinction of being known as the diabetes capital of the world. Epidemiological studies have shown that DM is under diagnosed and inadequately treated in our country. Insulin resistance and β-cell dysfunction are the two key pathophysiological determinants of the DM. The disease has metamorphosed during the last couple of decades with a significant change in the clinical presentation. Simultaneously, the therapeutic options for the management of DM have also increased in the last decade. This article highlights the research conducted by us over the last decade in the areas of pathogenesis, management, and complications of DM.

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“…The increased prevalence of type 1 DM is associated with a series of immune-mediated disorders, including vitiligo, alopecia areata, dermatitis herpetiformis, autoimmune thyroiditis, and Biermer’s anemia 99. Generalized eruptive clear cell syringomas are particularly associated with DM.…”

Section: Associated Diseasesmentioning

confidence: 99%

The skin landscape in diabetes mellitus. Focus on dermocosmetic management

Pierard¹,

Seité²,

Hermanns‐Lê³

et al. 2013

CCID

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BackgroundSome relationships are established between diabetes mellitus (DM) and a series of cutaneous disorders. Specific dermatoses are markers for undiagnosed DM. Other disorders represent supervening complications in an already treated DM patient.ObjectiveTo review the information about dermocosmetic care products and their appropriate use in the management and prevention of dermatoses related to DM.MethodThe peer-reviewed literature and empiric findings are covered. Owing to the limited clinical evidence available for the use of dermocosmetics, a review of the routine practices and common therapies in DM-related dermatoses was conducted.ResultsSome DM-related dermatoses (acanthosis nigricans, pigmented purpuric dermatosis) are markers of macrovascular complications. The same disorders and some others (xerosis, Dupuytren’s disease) have been found to be more frequently associated with microangiopathy. Other skin diseases (alopecia areata, vitiligo) were found to be markers of autoimmunity, particularly in type 1 DM. Unsurprisingly, using dermocosmetics and appropriate skin care has shown objective improvements of some DM-related dermatoses, such effects improve the quality of life. The most common skin manifestations of DM fall along continuum between “dry skin,” xerosis, and acquired ichthyosis, occurring predominately on the shins and feet. Dermocosmetic products improve the feeling of well-being for DM patients.

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Diabetes in young – unusual case presentation

Cited by 3 publications

References 8 publications

Unusual initial presentation of type 1 diabetes mellitus

Unusual initial presentation of type 1 diabetes mellitus

Novel Approaches in the Management of Type 2 Diabetes and Associated Vascular Complications

The skin landscape in diabetes mellitus. Focus on dermocosmetic management

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