University of Wisconsin–Madison Medical College of Wisconsin

Extremely Early Onset Type 1 Diabetes in the Emergency Setting: A Unique Presentation of a Common Childhood Onset Disease

Erin Whiteford, MD, MS; Amy Drendel, DO, MS

WMJ. 2024;123(6):614-618.

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ABSTRACT

Introduction: As the prevalence of type 1 and type 2 diabetes continues to increase, hospitals have developed protocols for managing its many complications, particularly diabetic ketoacidosis. However, extremely early onset type 1 diabetes, defined as onset at age < 2 years old, remains a diagnostic challenge to the community clinician.

Case Presentation: We report a case report of a 19-month-old female thought to have acute on chronic constipation who presented to our pediatric emergency department and was subsequently found to be in diabetic ketoacidosis.

Discussion: This case emphasizes the importance of maintaining a high suspicion for this potentially lethal disease presentation, as well as the variety of symptoms that can occur with it.

Conclusions: The limited communicative ability of the pediatric population often results in unclear or vague initial complaints at disease onset. This has led to a paucity of literature and knowledge surrounding the diagnosis of extremely early onset type 1 diabetes, making delayed diagnosis and its associated complications commonplace.


Author Affiliations: Children’s Hospital of Wisconsin – Milwaukee Campus and Medical College of Wisconsin and Affiliated Hospitals, Milwaukee, Wisconsin (Whiteford, Drendel).
Corresponding Author: Erin Whiteford, MD, MS, Children’s Hospital of Wisconsin – Milwaukee Campus, 8915 W Connell Ct, Milwaukee, WI 53226; email Ewhiteford@mcw.edu; ORCID ID 0009-0009-3658-3803
Funding/Support: None declared.
Financial Disclosures: None declared.
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