[Hyperglycemic, hyperosmolar nonketotic diabetic coma in the pediatric age]

Area of Science:

• Pediatric Endocrinology
• Diabetology
• Psychosomatic Medicine

Background:

• Non-ketotic hyperglycemic-hyperosmolar diabetic coma is a rare but serious complication of diabetes mellitus.
• While more common in adults, pediatric cases are exceptionally infrequent, with only 18 reported previously.
• The role of psychological stress in precipitating diabetic emergencies in children warrants further investigation.

Observation:

• A case report of an 8-year-old boy experiencing non-ketotic hyperglycemic-hyperosmolar diabetic coma is presented.
• The event was preceded by a period of severe mental trauma.
• This represents the 19th reported case in pediatric patients.

Findings:

• Virological and immunological investigations were conducted.
• Insulinogenic function and psychodiagnostic assessments were performed.
• The diagnosis, aetiopathogenesis, and therapeutic strategies for this unusual presentation were discussed.

Implications:

• This case underscores the potential link between severe psychological stress and diabetic ketoacidosis in children.
• Measuring plasma osmolarity is crucial for diagnosing and managing pediatric diabetic coma.
• Further research into the psychosomatic aspects of diabetes in children is recommended.