A case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngster
Type 2 diabetes (T2D) is a chronic condition caused by insulin resistance and relative insulin deficiency, leading to disrupted glucose homeostasis. Several genetic, behavioral, and socio-economic factors have been recognized as predisposing factors. The incidence of T2D in the pediatric population...
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| Format: | Article |
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Accademia Peloritana dei Pericolanti
2025-01-01
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| Series: | Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche |
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| Online Access: | https://cab.unime.it/journals/index.php/APMB/article/view/4663 |
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| author | Bruno Bombaci Fortunato Lombardo Stefano Passanisi Sara Aramnejad Rossella Morello Mariella Valenzise Giuseppina Salzano Malgorzata Gabriela Wasniewska |
| author_facet | Bruno Bombaci Fortunato Lombardo Stefano Passanisi Sara Aramnejad Rossella Morello Mariella Valenzise Giuseppina Salzano Malgorzata Gabriela Wasniewska |
| author_sort | Bruno Bombaci |
| collection | DOAJ |
| description | Type 2 diabetes (T2D) is a chronic condition caused by insulin resistance and relative insulin deficiency, leading to disrupted glucose homeostasis. Several genetic, behavioral, and socio-economic factors have been recognized as predisposing factors. The incidence of T2D in the pediatric population is increasing, paralleling the rise in obesity rates among youths. Early diagnosis and initiation of therapy are crucial to preventing or delaying long-term complications. We present the case of a 13-year-old Caucasian boy who presented with respiratory distress and altered consciousness, preceded by fever, cough, polyuria, and polydipsia. Blood gas analysis revealed metabolic acidosis (pH 7.1, Na 129.4 mmol/l, K 3.81 mmol/l, HCO3- 3.4 mmol/l, BE -23.65 mmol/l), ketonemia (4.8 mmol/l), and hyperglycemia (541 mg/dl), consistent with diabetic ketoacidosis. Further investigations, prompted by persistent respiratory distress and increased inflammatory markers, led to the diagnosis of complicated pneumonia. Based on clinical signs of insulin resistance (such as acanthosis nigricans), obesity (BMI 25.6 kg/m2), family history of T2D (father), and after excluding type 1 diabetes, monogenic, and other forms of diabetes, a diagnosis of T2D was eventually established. Following resolution of diabetic ketoacidosis, therapy with metformin was started, with prompt achievement of satisfactory glucose control. This case underscores the possible association between infections, accelerated metabolic decompensation, and severe diabetic ketoacidosis in individuals predisposed to T2D. |
| format | Article |
| id | doaj-art-33545c7e92984606910e6b6a91c40af3 |
| institution | Kabale University |
| issn | 1828-6550 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Accademia Peloritana dei Pericolanti |
| record_format | Article |
| series | Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche |
| spelling | doaj-art-33545c7e92984606910e6b6a91c40af32025-08-20T03:51:18ZengAccademia Peloritana dei PericolantiAtti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche1828-65502025-01-0111221410.13129/1828-6550/APMB.112.2.2024.CCS13733A case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngsterBruno Bombaci0Fortunato Lombardo1Stefano Passanisi2Sara Aramnejad3Rossella Morello4Mariella Valenzise5Giuseppina Salzano6Malgorzata Gabriela Wasniewska7<span class="x193iq5w xeuugli x13faqbe x1vvkbs x1xmvt09 x1lliihq x1s928wv xhkezso x1gmr53x x1cpjm7i x1fgarty x1943h6x xudqn12 x3x7a5m x6prxxf xvq8zen xo1l8bm xzsf02u x1yc453h" dir="auto">Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina</span>Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina<strong> </strong>Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina<strong> </strong>Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina<strong> </strong>Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina<strong> </strong>Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina<strong> </strong>Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of MessinaDepartment of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of MessinaType 2 diabetes (T2D) is a chronic condition caused by insulin resistance and relative insulin deficiency, leading to disrupted glucose homeostasis. Several genetic, behavioral, and socio-economic factors have been recognized as predisposing factors. The incidence of T2D in the pediatric population is increasing, paralleling the rise in obesity rates among youths. Early diagnosis and initiation of therapy are crucial to preventing or delaying long-term complications. We present the case of a 13-year-old Caucasian boy who presented with respiratory distress and altered consciousness, preceded by fever, cough, polyuria, and polydipsia. Blood gas analysis revealed metabolic acidosis (pH 7.1, Na 129.4 mmol/l, K 3.81 mmol/l, HCO3- 3.4 mmol/l, BE -23.65 mmol/l), ketonemia (4.8 mmol/l), and hyperglycemia (541 mg/dl), consistent with diabetic ketoacidosis. Further investigations, prompted by persistent respiratory distress and increased inflammatory markers, led to the diagnosis of complicated pneumonia. Based on clinical signs of insulin resistance (such as acanthosis nigricans), obesity (BMI 25.6 kg/m2), family history of T2D (father), and after excluding type 1 diabetes, monogenic, and other forms of diabetes, a diagnosis of T2D was eventually established. Following resolution of diabetic ketoacidosis, therapy with metformin was started, with prompt achievement of satisfactory glucose control. This case underscores the possible association between infections, accelerated metabolic decompensation, and severe diabetic ketoacidosis in individuals predisposed to T2D.https://cab.unime.it/journals/index.php/APMB/article/view/4663obesitypediatricstype 1 diabetestype 2 diabetes |
| spellingShingle | Bruno Bombaci Fortunato Lombardo Stefano Passanisi Sara Aramnejad Rossella Morello Mariella Valenzise Giuseppina Salzano Malgorzata Gabriela Wasniewska A case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngster Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche obesity pediatrics type 1 diabetes type 2 diabetes |
| title | A case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngster |
| title_full | A case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngster |
| title_fullStr | A case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngster |
| title_full_unstemmed | A case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngster |
| title_short | A case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngster |
| title_sort | case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngster |
| topic | obesity pediatrics type 1 diabetes type 2 diabetes |
| url | https://cab.unime.it/journals/index.php/APMB/article/view/4663 |
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