Difficult Management of Glucose Homeostasis in a 21-Month-Old Child With Type 1 Diabetes and Unknown Glutaric Aciduria Type I: A Case Report
| Autor: | Grazia Morandi, Anita Morandi, Genan Anton, Daniela Degani, A. Sabbion, Claudio Maffeis, Marco Marigliano |
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| Rok vydání: | 2013 |
| Předmět: |
Advanced and Specialized Nursing
Glycosuria Opisthotonus Type 1 diabetes medicine.medical_specialty Pediatrics type 1 diabetes business.industry Endocrinology Diabetes and Metabolism children type-I glutaric aciduria medicine.disease Hypotonia Endocrinology Internal medicine Diabetes mellitus Internal Medicine medicine Glucose homeostasis Ketonuria Online Letters: Observations Base excess medicine.symptom business |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc13-0724 |
| Popis: | A 21-month-old boy with previously diagnosed type 1 diabetes was admitted to our unit, presenting with glycometabolic failure (pH 7.30; base excess −11.9 mmol/L; blood glucose 17.3 mmol/L; HbA1c 10.4% [90 mmol/mol]; glycosuria; and ketonuria). During physical examination he was dehydrated and pale and presented with axial hypotonia with hyposthenia, poor head control, hypotonic legs, and hyporeflexia. His neurological clinical status became compromised after the diagnosis of type 1 diabetes when he was 15 months old. During hospitalization, the management of blood glucose homeostasis was difficult because of a high level of glycemic variability. Hypo- and hyperglycemic episodes were associated with acute encephalopathic crises characterized by hypotonia, dyskinetic movements, difficulty swallowing, and episodes of opisthotonus with no loss of consciousness. For better control of blood glucose, subcutaneous insulin treatment was … |
| Databáze: | OpenAIRE |
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