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Early-Onset Type 2 Diabetes Misdiagnosed as Type 1 Diabetes in a 15-Year-Old Nigerian Girl: A Case Report

Case Reports in Clinical Medicine 2020年第4期9卷 107-114页

作者： Adeyemi Michael Olamoyegun Oluwabukola Ayodele Ala olayinka olomooba saliu Department of Internal Medicine Endocrinology Diabetes & Metabolism Unit LAUTECH Teaching Hospital Ogbomoso Nigeria College of Health Sciences Faculty of Clinical Sciences Ladoke Akintola University of Technology Ogbomoso Nigeria Department of Medicine Bowen University/Bowen University Teaching Hospital (BUTH) Ogbomoso Nigeria Department of Internal Medicine LAUTECH Teaching Hospital Ogbomoso Nigeria

Type 2 diabetes mellitus (T2DM) is emerging as a new clinical disorder among children and adolescents. Although there is increasing prevalence of this clinical entity among adolescents worldwide, its diagnosis among Nigerian children and adolescents is still uncommon, hence, the reason many physicians still misdiagnose T2DM in adolescents as type 1 diabetes mellitus for reason of age of onset. Here, we present a 15-year old, overweight, girl who presented with history of polyuria, polydipsia and weight loss;her blood glucose level was 14.3 mmol/l, glycated haemoglobin 12.4% and glycosuria (3+), with no ketonuria or proteinuria. She was initially diagnosed as type 1 diabetes and managed with multiple doses of insulin by the pediatric team until she was later reviewed by the endocrinology unit. The diagnosis was later changed to early-onset T2DM (Youth-onset T2DM) based on a BMI of 29.75 kg/m2, presence of acanthosis nigricans, absence of ketosis, preserved beta-cell function as shown by normal serum C-peptide levels, absence of anti-glutamic acid decarboxylase (GAD) antibodies and islet cell antibody, and also response to oral anti-diabetic agents while her insulin therapy was discontinued. Therefore, a possibility of T2DM should be suspected in childhood and adolescent with diabetes associated with overweight or obesity, relatives with T2DM and features of insulin resistance (IR) like acanthosis nigricans, hypertension, dyslipidaemia, non-alcoholic fatty liver disease (NAFLD), hyperandrogenism, or polycystic ovarian syndrome (PCOS).

关键词： Type 1 Diabetes Mellitus Type 2 Diabetes Mellitus Adolescent Misdiagnosis Acanthosis Nigricans Nigerians

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