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

Erin Whiteford1, Amy Drendel2

  • 1Children's Hospital of Wisconsin - Milwaukee Campus and Medical College of Wisconsin and Affiliated Hospitals, Milwaukee, Wisconsin, Ewhiteford@mcw.edu.

WMJ : Official Publication of the State Medical Society of Wisconsin
|February 5, 2025
PubMed

Insights

Extremely early onset type 1 diabetes in children under two presents diagnostic challenges. This case highlights the varied symptoms and need for high clinical suspicion in young children with diabetic ketoacidosis.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Clinical Diagnostics

Background:

  • Rising prevalence of type 1 and type 2 diabetes necessitates robust management protocols for complications like diabetic ketoacidosis.
  • Extremely early onset type 1 diabetes (onset < 2 years) poses significant diagnostic challenges for community clinicians.

Observation:

  • A 19-month-old female presented with symptoms initially attributed to acute on chronic constipation.
  • The patient was diagnosed with diabetic ketoacidosis upon presentation to the pediatric emergency department.

Findings:

  • Delayed diagnosis of extremely early onset type 1 diabetes is common due to vague initial symptoms in non-verbal pediatric patients.
  • This case underscores the diverse clinical presentations of diabetic ketoacidosis in very young children.

Implications:

  • Clinicians must maintain a high index of suspicion for diabetic ketoacidosis in young children, even with non-specific symptoms.
  • Increased awareness and diagnostic vigilance are crucial to prevent severe complications associated with delayed diagnosis of early-onset type 1 diabetes.
Abstract

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