Cutaneous mucormycosis as a presenting feature of type 1 diabetes in a boy – case report and review of the literature

2018 ◽  
Vol 31 (6) ◽  
pp. 689-692
Author(s):  
Ganesh Jevalikar ◽  
Siddhnath Sudhanshu ◽  
Sanjay Mahendru ◽  
Smita Sarma ◽  
Khalid J. Farooqui ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Rare Complication ◽  
Middle Finger ◽  
Surgical Debridement ◽  
Antifungal Treatment ◽  
Onset Of Diabetes ◽  
Cutaneous Mucormycosis ◽  
High Index Of Suspicion ◽  
Surgery Department

Abstract Background: Mucormycosis is a potentially fatal complication of diabetes. The rhino-orbito-cerebral form is the most common presentation, however, rarely other types can also be seen. Case presentation: We describe the case of a 4½ -year-old boy not previously known to be a diabetic who presented to the plastic surgery department for gangrene of the left middle finger with surrounding erythema and induration. After the diagnosis of diabetes and initial treatment, pus from the wound showed broad aseptate hyphae suggestive of mucormycosis which was further confirmed on culture. Aggressive surgical debridement including amputation, antifungal treatment and glycemic control achieved a complete cure. Conclusions: Cutaneous mucormycosis is a rare complication of type 1 diabetes mellitus and can even be seen at the onset of diabetes. High index of suspicion, timely antifungal treatment and aggressive surgical debridement usually lead to recovery in the localized form of the disease.

Validation of a model for the prediction of retinopathy in persons with type 1 diabetes

2019 ◽  
pp. bjophthalmol-2018-313539
Author(s):  
Vivian Schreur ◽  
Heijan Ng ◽  
Giels Nijpels ◽  
Einar Stefánsson ◽  
Cees J Tack ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Hospital Setting ◽  
Predictive Performance ◽  
Individual Risk ◽  
Screening Interval ◽  
C Statistic ◽  
Onset Of Diabetes ◽  
Screening Frequency

Background/AimTo validate a previously developed model for prediction of diabetic retinopathy (DR) for personalised retinopathy screening in persons with type 1 diabetes.MethodsRetrospective medical data of persons with type 1 diabetes treated in an academic hospital setting were used for analysis. Sight-threatening retinopathy (STR) was defined as the presence of severe non-proliferative DR, proliferative DR or macular oedema. The presence and grade of retinopathy, onset of diabetes, systolic blood pressure, and levels of haemoglobin A1c were used to calculate an individual risk estimate and personalised screening interval. In persons with STR, the occurrence was compared with the calculated date of screening. The model’s predictive performance was measured using calibration and discrimination techniques.ResultsOf the 268 persons included in our study, 24 (9.0%) developed STR during a mean follow-up of 4.6 years. All incidences of STR occurred after the calculated screening date. By applying the model, the mean calculated screening interval was 30.5 months, which is a reduction in screening frequency of 61% compared with annual screening and 21% compared with biennial screening. The discriminatory ability was good (Harrell’s C-statistic=0.82, 95% CI 0.74 to 0.90), and calibration showed an overestimation of risk in persons who were assigned to a higher risk for STR.ConclusionThis validation study suggests that a screening programme based on the previously developed prediction model is safe and efficient. The use of a personalised screening frequency could improve cost-effectiveness of diabetic eye care.

scholarly journals Liver disease in children and Adolescents with Type1 Diabetes Mellitus

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M H Elsayed ◽  
M T Hamza ◽  
M M Elsaeed ◽  
R A F Thabet
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Liver Disease ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Liver Enzymes ◽  
Rare Complication ◽  
Elevated Liver Enzymes ◽  
Liver Transaminases

Abstract Glycogenic hepatopathy (GH) is a very rare complication seen mostly in patients with type 1 diabetes mellitus (T1DM) in whom glycemic control has been poor for a long time. We assessed liver diseases in children and adolescents with type 1 diabetes mellitus by detection of elevated liver transaminases and confirmed by fibro scan and ultrasound. One hundred and seven children and adolescents with T1DM were subjected to detailed history, physical examination, laboratory investigation and radiological investigation. Liver transaminases, mean HbA1c and pelviabdominal ultrasound were done for all patients while fibro scan for those with elevated liver enzymes only. Patients with elevated liver enzymes were reassessed after one year. Only nine of our patients have elevated liver enzymes. HbA1c and fibro scan abnormalities (F stage) were significantly higher in patients with elevated liver enzymes. (p < 0.001) After follow up a significant decrease in liver enzymes, fibro scan abnormalities and HbA1c in the group with elevated liver enzymes initially was detected. (p < 0.001) We concluded that liver disease is not a common complication in patients with long standing uncontrolled diabetes which can be reversed after proper control.

scholarly journals A very rare complication of type 1 diabetes: insulin edema developed in a newly diagnosed type 1 diabetes

2013 ◽  
Vol 48 (1) ◽  
pp. 62-64
Author(s):  
Tolga Altug Sen ◽  
Aysegul Bukulmez ◽  
Adnan Narci ◽  
Meltem Ugras ◽  
Ozlem Guraksin ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Rare Complication ◽  
Newly Diagnosed

Hip Strength in Adults With Type 1 Diabetes is Associated With Age at Onset of Diabetes

2012 ◽  
Vol 15 (1) ◽  
pp. 78-85 ◽  
Author(s):  
Raelene E. Maser ◽  
Paul Kolm ◽  
Christopher M. Modlesky ◽  
Thomas J. Beck ◽  
M. James Lenhard
Keyword(s):  
Type 1 Diabetes ◽  
Age At Onset ◽  
Hip Strength ◽  
Onset Of Diabetes

scholarly journals The Prevalence of Type 1 Diabetes in Children of Mazandaran Province

2018 ◽  
Author(s):  
Daniel Zamanfar ◽  
Pooneh Yazdani ◽  
Mohsen Aarabi ◽  
Hedieh Pournorooz
Keyword(s):  
Type 1 Diabetes ◽  
Age Of Onset ◽  
Cross Sectional Study ◽  
Delivery Method ◽  
Mazandaran Province ◽  
Cross Sectional ◽  
Onset Of Diabetes ◽  
The Mean ◽  
First Time

Introduction: The prevalence of type 1 diabetes in all countries throughout the world is different. In this study, an introduction is, therefore, provided for the development of type 1 diabetes in children in Mazandaran province by using all available resources.Methods: In this descriptive cross-sectional study, the prevalence of patients with initial diagnosis of type 1 diabetes mellitus, aging from 6 months to 18 years, was located through contacting and referring to all organizations of insurers and doctors or experts in children endocrinologist and adolescent diseases in Mazandaran province.Results: 289 patients with type 1 diabetes were identified, 138 of whom were male (47.8%), and 151 were women (52.2%) with an overall prevalence of 0.04%, and the rate of this prevalence was 48 cases among 100000 people (50 cases among 100000 girls and 36 cases among 100000 boys). The mean age of the patients was 11.5 years old. In the study of delivery method, 180 patients (62.3%) were diagnosed with cesarean section, and 109 (37.7%) were born through natural delivery method. The mean age of onset of diabetes was 7 years. The minimum and maximum ages were 7 months and 18 years, respectively. 97 (33.6%) of the patients were also hospitalized for the first time due to ketoacidosis, and were diagnosed with diabetes.Conclusion: Type 1 diabetes in Mazandaran province was more prevalent than the similar study in southern Iran and neighboring countries. It is essential to pay greater attention to this disease through studying it in the other parts of the country.

Prevalence of chronic complications in patients with over 30-year history of type 1 diabetes depending on the age of onset of diabetes

2014 ◽  
Vol 20 (4) ◽  
pp. 143-151
Author(s):  
Dorota Pisarczyk-Wiza ◽  
◽  
Dorota Zozulińska-Ziółkiewicz ◽  
Stanisław Piłaciński ◽  
Magdalena Milcarek ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age Of Onset ◽  
Chronic Complications ◽  
History Of ◽  
Onset Of Diabetes

scholarly journals Fulminant Type 1 Diabetes as a Model of Nature to Explore the Role of C-Peptide

2008 ◽  
Vol 2008 ◽  
pp. 1-2
Author(s):  
Yuko Murase-Mishiba ◽  
A. Imagawa ◽  
Toshiaki Hanafusa
Keyword(s):  
Type 1 Diabetes ◽  
Physiological Role ◽  
Chronic Complications ◽  
Fulminant Type 1 Diabetes ◽  
C Peptide ◽  
Onset Of Diabetes ◽  
Fulminant Type

Patients with fulminant type 1 diabetes almost completely lack C-peptide even soon after the onset of the disease, and the deficiency continues for the rest of their life. Thus, fulminant type 1 diabetes could serve as a good model of nature to explore the physiological role of C-peptide. For example, patients with fulminant type 1 diabetes have diabetic chronic complications more frequently than those with classical autoimmune type 1 diabetes 5 years after the onset of diabetes, and the higher prevalence could be partly attributable to the complete lack of C-peptide in fulminant type 1 diabetes.

Revisit of a rare complication of type 1 diabetes mellitus: Mauriac syndrome

2017 ◽  
Vol 34 (4) ◽  
pp. 132-134 ◽  
Author(s):  
Umang G Thakkar ◽  
Aruna V Vanikar ◽  
Hargovind L Trivedi
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Rare Complication ◽  
Mauriac Syndrome

scholarly journals Exercise-Induced Hypoglycemic Hemiplegia in a Child with Type 1 Diabetes: A Rare Find with Multiple Potential Causative Mechanisms

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
M. Constantine Samaan ◽  
Abeer Alassaf ◽  
Jonathan DellaVedova ◽  
Trisha Murthy
Keyword(s):  
Type 1 Diabetes ◽  
Motor Neurons ◽  
Intracellular Signaling ◽  
Rare Complication ◽  
Sudden Onset ◽  
The Body ◽  
Neurological Deficits ◽  
Oral Glucose ◽  
Normal Brain

A 10-year-old boy known to have type 1 diabetes presented to the emergency department with history of sudden onset of right-sided hemiplegia after exercise. He did not respond to oral glucose administration, but had an almost immediate resolution of symptoms with intravenous bolus of dextrose. Hemiplegic hypoglycemia is a rare complication in diabetic children, mostly affects the right side of the body, and is rarely recurrent. Children have normal brain imaging and angiography testing, and electroencephalogram may show slow-wave activity. The recovery takes place within 24 hours, and the prognosis is excellent with no focal neurological deficits noted. Our patient responded within minutes to intravenous dextrose, which is unusual and has not been reported previously. The mechanisms leading to development of hypoglycemic hemiplegia are unclear, but may involve effects of hypoglycemia on intracellular signaling pathways or molecules on motor neurons, as recent studies have shown normal brain cell glucose uptake and metabolism in hypoglycemia. While hypoglycemic hemiplegia is rare, it is a frightening experience to caregivers, and efforts should concentrate on its prevention by preventing hypoglycemia.

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