Pediatric stroke as the presenting symptom of new-onset type 1 diabetes mellitus without DKA: case report and literature review

Abstract

Background Stroke and other neurologic complications are rare in pediatric type 1 diabetes mellitus (T1DM) without severe diabetic ketoacidosis (DKA) or poor glycemic control. Case presentation A previously healthy, 10-year-old female presented with acute thalamic stroke, non-acidotic new T1DM diagnosis and negative hypercoagulopathy workup. She received routine insulin therapy and aspirin, and returned to neurologic baseline within a year without stroke recurrence. Conclusions The contribution of non-acidotic hyperglycemia to stroke risk is better described in adults. Even though unable to prove causality, this case should at least raise awareness of the possible association of pediatric new-onset diabetes and stroke for optimal outcomes.

Ischemic-Hemorrhagic Stroke in New Onset Type 1 Diabetes Mellitus with Diabetic Ketoacidosis in a Two-Year-Old Toddler: The First Reported Case in Indonesia

“…Meanwhile, in Indonesia, the awareness of T1DM is low; around 71% of T1DM cases were diagnosed at the onset with DKA [5]. Neurological complications of DKA require the presence of severe DKA or chronically poor glycemic control [6]. Those include cerebral edema, which occurs in 6.8 per 1000 DKA cases, and stroke [7].…”

“…Those include cerebral edema, which occurs in 6.8 per 1000 DKA cases, and stroke [7]. Stroke, both ischemic and hemorrhagic, is rare, accounting for 10% of intracerebral complications in DKA [6][7][8][9][10]. Recognition may be challenging when symptoms and signs mimic those of cerebral edema [9].…”