A Rare Presentation of New-Onset Type 1 Diabetes Mellitus in a Developmentally Delayed Child With an Overlap of Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

Maria G Parra Villasmil; Shruti Patel; Michael Tansey; Aditya Badheka; Madhuradhar Chegondi

doi:10.7759/cureus.28983

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A Rare Presentation of New-Onset Type 1 Diabetes Mellitus in a Developmentally Delayed Child With an Overlap of Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

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A Rare Presentation of New-Onset Type 1 Diabetes Mellitus in a Developmentally Delayed Child With an Overlap of Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

Maria G Parra Villasmil, Shruti Patel, Michael Tansey, Aditya Badheka and Madhuradhar Chegondi

Curēus (Palo Alto, CA), Vol.14(9)

09/09/2022

DOI: 10.7759/cureus.28983

PMCID: PMC9548379

PMID: 36237743

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Abstract

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are serious complications associated with diabetes mellitus (DM). HHS is a common diagnosis in adults but rare in children. DKA is a usual presentation for new-onset type 1 DM, although HHS is rarely a manifestation of new-onset type 1 DM. Diagnosis and management of HHS are challenging in pediatric patients, especially if they present with a mixed picture of HHS and DKA. We report an adolescent female with a new onset of type 1 DM presented as mixed DKA and HHS. Treatment included meticulous management of fluids and continuous insulin drip with the resolution of acidosis within 24 hours and hyperosmolar state at 96 hours of admission. Early differentiation of these two entities and meticulous fluid management improves the outcome and decreases the risk of complications such as cerebral edema, renal failure, and thrombosis, among others.

Diabetes

Endocrinology

Metabolism

Pediatrics

adolescent

developmentally delayed children

diabetes mellitus

diabetic ketoacidosis

hyperglycemic hyperosmolar state

Details

Title: Subtitle: A Rare Presentation of New-Onset Type 1 Diabetes Mellitus in a Developmentally Delayed Child With an Overlap of Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State
Creators: Maria G Parra Villasmil - Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, USA
Shruti Patel - University of Iowa
Michael Tansey - University of Iowa
Aditya Badheka - University of Iowa
Madhuradhar Chegondi - University of Iowa
Resource Type: Journal article
Publication Details: Curēus (Palo Alto, CA), Vol.14(9)
DOI: 10.7759/cureus.28983
PMID: 36237743
PMCID: PMC9548379
NLM abbreviation: Cureus
ISSN: 2168-8184
eISSN: 2168-8184
Publisher: Cureus
Language: English
Date published: 09/09/2022
Academic Unit: Endocrinology and Diabetes; Critical Care; Stead Family Department of Pediatrics; Fraternal Order of Eagles Diabetes Research Center
Record Identifier: 9984354520102771

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