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Rare and unexpected cause of diabetes in a teenager
  1. Taffy Makaya1,
  2. Aishatu Ali2,
  3. Supriyo Basu3
  1. 1 Department of Paediatric Endocrinology, Oxford University Hospitals NHS trust Foundation Trust, Oxford, Oxfordshire, UK
  2. 2 Department of Paediatric Endocrinology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
  3. 3 Department of Paediatric Endocrinology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
  1. Correspondence to Dr Aishatu Ali, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; aishatu.ali{at}nhs.net

https://doi.org/10.1136/archdischild-2018-315857

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    Background

    A 15-year-old boy whose family originated from Pakistan presented with polyuria, polydipsia, abdominal pain and weight loss (WL). There was a complex three-generational family history of type 1 (T1DM) and type 2 diabetes mellitus (T2DM). The patient’s two paternal uncles had been reportedly diagnosed with T2DM; his mother and maternal uncle had T2DM. Another maternal uncle had been reportedly diagnosed with diabetes when aged 15 years, initially T2DM but requiring insulin. Both maternal grandparents had T2DM diagnosed when aged 30–40 years. The patient’s two maternal cousins were in our care with T1DM.

    Examination revealed mild epigastric tenderness, with moderate dehydration. Blood tests showed high blood glucose (BG): 18.8 mmol/L (NR: 4–7 mmol/L) and HbA1C: 90 mmol/mol (20–42 mmol/mol). Blood ketones were negative. Serum amylase was 185 IU/L(25-125 IU/L).

    Diabetes autoantibodies (islet cell, islet antigen 2, glutamic acid decarboxylase) were all negative. In view of the negative diabetes autoantibodies and the extensive family history of T1DM and T2DM, an oral …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.