New-onset diabetes in an obese adolescent: diagnostic dilemmas

Nature Clinical Practice. Endocrinology & Metabolism
Christina M Gerhardt, Georgeanna J Klingensmith

Abstract

A 14-year-old, obese, African American boy presented to his pediatrician with polyuria, polydipsia, and a significant unintentional weight loss. He was dehydrated, with high levels of blood sugar and urinary ketones. He had no history of previous illnesses and was not taking any medications. He had a family history of type 2 diabetes mellitus. Physical examination included assessing stigmata of insulin resistance, and measuring blood pressure, pulse, and BMI. Blood samples were obtained for measurement of venous blood pH, bicarbonate, serum glucose, electrolytes, HbA(1C), aminotransferases and lipids. Urine was sampled for measurement of ketones. Subsequently, measurements of fasting C-peptide and immunoassays for insulin autoantibodies (IAA), islet-cell autoantibodies (ICA-512) and glutamic acid decarboxylase autoantibodies (GAD-65) were performed. New-onset diabetes mellitus with diabetic ketoacidosis, initially diagnosed as type 2 diabetes mellitus, but later determined as type 1 diabetes mellitus. After treatment of diabetic ketoacidosis with hydration and insulin infusion, the patient was discharged on subcutaneous insulin. He was diagnosed with type 2 diabetes mellitus and was transferred to oral insulin-sensitizing agent...Continue Reading

References

Apr 1, 1997·Diabetes Care·O Pinhas-HamielP S Zeitler
Dec 24, 2004·Diabetes Care·Janet SilversteinUNKNOWN American Diabetes Association
Oct 26, 2005·Journal of Autoimmunity·Lisa K GilliamCatherine Pihoker
Mar 8, 2006·Annals of Internal Medicine·Guillermo E UmpierrezAbbas E Kitabchi
Oct 26, 2006·The Journal of Clinical Endocrinology and Metabolism·Jian WangLiping Yu
Jun 28, 2007·JAMA : the Journal of the American Medical Association·UNKNOWN Writing Group for the SEARCH for Diabetes in Youth Study GroupBeth Waitzfelder
Oct 19, 2007·Proceedings of the National Academy of Sciences of the United States of America·Janet M WenzlauJohn C Hutton
Oct 30, 2007·The Medical Clinics of North America·Danielle Lann, Derek LeRoith
Jan 10, 2008·Diabetes Care·UNKNOWN American Diabetes Association

❮ Previous
Next ❯

Citations

Nov 28, 2008·American Journal of Physiology. Heart and Circulatory Physiology·Susan A MarshJohn C Chatham
Feb 7, 2009·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·H YadavF Marotta
Aug 24, 2013·Journal of Healthcare Engineering·Diana MassaiUmberto Morbiducci
Nov 26, 2009·Current Opinion in Lipidology

❮ Previous
Next ❯

Related Concepts

Related Feeds

Biomarkers for Type 2 Diabetes

Biomarkers can help understand chronic diseases and assist in risk prediction for prevention and early detection of diseases. Here is the latest research on biomarkers in type 2 diabetes, a disease in which the body is unable to produce or properly use insulin.