Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case report

Objective: To report a Saudi young patient with early onset type 2 diabetes, who was misdiagnosed for 6 years as type 1 diabetic. Case Report: A Saudi male aged 18-year old presented with uncontrolled diabetes. He was diagnosed 6 years earlier to have type 1 diabetes mellitus. He was kept insulin, b...

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Main Author: Hassan M Al-Musa
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Journal of Family Medicine and Primary Care
Subjects:
Online Access:http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=1;spage=313;epage=315;aulast=Al-Musa
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author_facet Hassan M Al-Musa
author_sort Hassan M Al-Musa
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description Objective: To report a Saudi young patient with early onset type 2 diabetes, who was misdiagnosed for 6 years as type 1 diabetic. Case Report: A Saudi male aged 18-year old presented with uncontrolled diabetes. He was diagnosed 6 years earlier to have type 1 diabetes mellitus. He was kept insulin, but he was not compliant to treatment and his blood glucose kept on fluctuating and not controlled. He came to our diabetes center for management of his uncontrolled diabetes. There was no past history of hospitalization. His father was type 2 diabetic. His body mass index was 46.7 kg/m2. His glycosylated hemoglobin (HbA1c) level was 9.9%. Immune dysfunction was evaluated using serum antibody levels of glutamic acid decarboxylase, which proved to be negative (0.7 U/mL), while serum C-peptide level was not low (2.2 ng/mL). Therefore, the patient was diagnosed as early onset type 2 diabetic, not type 1 diabetic. The patient was advised to start physical exercise through daily walking for at least 1 h. The dietitian planned a strict diet plan for him to follow. Insulin injections and Metformin tablets were started. The patient received detailed health education on nature and management of his condition. After 4 months, his body mass index became 39.4 kg/m2 and his HbA1c became 6%. Insulin was stopped, and he was advised to continue on metformin, the diet, and daily walking. Two months later, his body mass index was 37.7 kg/m2 and his HbA1c became 5.41%. Conclusions: Early onset type 2 diabetes should be suspected among obese children with symptoms of diabetes. Proper health education and patient's compliance to medication, diet, and physical activity are essential for successful management of early onset type 2 diabetes. Moreover, primary care physicians need to be aware that type 2 diabetes is not necessarily adult-onset.
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spelling doaj.art-6396cd8236e942edb414e09853d0f49c2022-12-22T03:44:20ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632019-01-018131331510.4103/jfmpc.jfmpc_426_18Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case reportHassan M Al-MusaObjective: To report a Saudi young patient with early onset type 2 diabetes, who was misdiagnosed for 6 years as type 1 diabetic. Case Report: A Saudi male aged 18-year old presented with uncontrolled diabetes. He was diagnosed 6 years earlier to have type 1 diabetes mellitus. He was kept insulin, but he was not compliant to treatment and his blood glucose kept on fluctuating and not controlled. He came to our diabetes center for management of his uncontrolled diabetes. There was no past history of hospitalization. His father was type 2 diabetic. His body mass index was 46.7 kg/m2. His glycosylated hemoglobin (HbA1c) level was 9.9%. Immune dysfunction was evaluated using serum antibody levels of glutamic acid decarboxylase, which proved to be negative (0.7 U/mL), while serum C-peptide level was not low (2.2 ng/mL). Therefore, the patient was diagnosed as early onset type 2 diabetic, not type 1 diabetic. The patient was advised to start physical exercise through daily walking for at least 1 h. The dietitian planned a strict diet plan for him to follow. Insulin injections and Metformin tablets were started. The patient received detailed health education on nature and management of his condition. After 4 months, his body mass index became 39.4 kg/m2 and his HbA1c became 6%. Insulin was stopped, and he was advised to continue on metformin, the diet, and daily walking. Two months later, his body mass index was 37.7 kg/m2 and his HbA1c became 5.41%. Conclusions: Early onset type 2 diabetes should be suspected among obese children with symptoms of diabetes. Proper health education and patient's compliance to medication, diet, and physical activity are essential for successful management of early onset type 2 diabetes. Moreover, primary care physicians need to be aware that type 2 diabetes is not necessarily adult-onset.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=1;spage=313;epage=315;aulast=Al-MusaCompliancedietearly onset type 2 diabetesphysical exercise
spellingShingle Hassan M Al-Musa
Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case report
Journal of Family Medicine and Primary Care
Compliance
diet
early onset type 2 diabetes
physical exercise
title Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case report
title_full Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case report
title_fullStr Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case report
title_full_unstemmed Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case report
title_short Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case report
title_sort early onset type 2 diabetes mellitus in a saudi child misdiagnosed as type 1 diabetic a case report
topic Compliance
diet
early onset type 2 diabetes
physical exercise
url http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=1;spage=313;epage=315;aulast=Al-Musa
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