Abstract
Background Diabetes is one of the most common chronic diseases with day by day increasing incidence(1). Globally,one in eleven adults have diabetes mellitus (90% have type 2 diabetes mellitus), and South East Asia is the epicentre of this global T2DM epidemic. Factors responsible for T2DM can be irreversible such as, genetic, age ethnicity race, and or revisable such as physical activity diet, and smoking.(2,3) Dietary choices and physical inactivity are the major reasons for the rapidly rising incidence of DM (3). The prevalence of type 2 diabetes in youth is increasing and pathophysiology clearly differs from type 1 diabetes: insulin resistance and nonautoimmune β-cell failure are underlying factors for T2DMbut little is known regarding related complications (4–6). This case report will help the physicians to develop best practices for evaluating and treating young-onset T2DM and help to fill gaps in our understanding of normal and abnormal glucose metabolism during adolescence and the long-term outcomes of youth-onset type 2 diabetes(5).
Case Report(s) 12-year 12-year-old young girl presented in the consultant clinic along with her parents. On 1st time presentation to the primary care physician, she had a 4 to 5 days history of increased frequency of urine and thirst, at that time her RBS was 610mg/dl with no evidence of ketones in her urine, upon refusal of caregivers to start insulin the primary care physician referred her to a specialist. Being the only child of parents, she had a very bizarre lifestyle and eating habits, she was found to be physically inactive and consume fast food on most the days of week without any medication her blood sugar level was found to be 430 mg/dl after 5 days in the specialist clinic by just dietary modifications. Further lab workup like urine DR revealed 4plus sugar with no ketones and raised fasting insulin and C-peptide level; normal thyroid function tests, negative autoantibodies (GAD-65, IA2, TTG IGA, IGG) screen. The patient and her caregiver were counseled about the importance of diet and lifestyle modifications to control blood sugar levels she was prescribed insulin- sensitizing medication (Metformin) 500mg twice a day. On follow up she has improvement in her blood sugar level. Continued diet and lifestyle modifications she achieved and maintained good glycemic control only with a single medication.
Conclusion(s) Type 2 DM must be kept in mind when dealing with youth onset hyperglycemia. Lifestyle modification and healthy dietary habits played a central role in achieving target glycemic control.
