15 year old girl in coma, suddenly discovered diabetes

Ho Chi Minh City Nhi, 15 years old, had high fever, vomiting, coma, was hospitalized for emergency treatment, doctors discovered she had type 1 diabetes causing complications.

Before being hospitalized, Nhi had a fever, was thirsty, and urinated a lot. She drank a lot of soft drinks and electrolyte water to quench her thirst, leading to vomiting and coma.

On December 9, Dr. Nguyen Duy Khuong, Department of Intensive Care and Anti-Poisoning (ICU), Tam Anh General Hospital, Ho Chi Minh City, said that the patient had typical symptoms of diabetic ketoacidosis (accumulation of many acidic ketone metabolites in the blood) such as coma, thirst, frequent urination, vomiting, and fruity breath odor. Blood sugar measurement results were 4 times higher, HbA1c index (average blood sugar over three months) was nearly triple, and blood ketones were 137 times higher than normal.

Doctor Duy said the patient had respiratory infection, ketoacidosis, type 1 diabetes, and no complications of ketoacidosis such as kidney failure, liver failure...

After three days of intensive treatment with intravenous insulin and fluid replacement, Nhi regained consciousness. Before being discharged from the hospital, the doctor advised the patient and her family on how to monitor blood sugar daily.

Dr. Nguyen Thi Thanh Truc, Department of Endocrinology - Diabetes, said that type 1 diabetes is often first detected when the patient has ketoacidosis, similar to the condition of Nhi patient when admitted to the hospital.

Type 1 diabetes is a chronic autoimmune disease, meaning the body produces antibodies against the patient's own internal organs, specifically the pancreas. This destructive process can occur for months or years until the pancreas cannot produce insulin, leading to a complete lack of insulin, unable to balance blood sugar, causing high blood sugar.

Type 1 diabetes is treated with insulin injections. Both children and adults can get type 1 diabetes. However, it is more common in children under 20 years of age.

Doctor Truc checks the patient's health before leaving the hospital. Photo: Dinh Tien — Doctor Truc checks the patient's health before leaving the hospital. Photo: *Dinh Tien*

It is not yet known exactly what causes the immune system to attack insulin-producing cells, causing type 1 diabetes. The disease usually progresses for several months to several years before the first symptoms are noticed.

Common symptoms include frequent urination, thirst, increased appetite, and weight loss. Other symptoms include fatigue, blurred vision, frequent skin infections, urinary or vaginal infections, and bedwetting that may appear in children who have not had them before.

More severe symptoms of type 1 diabetes can include restlessness, confusion, rapid deep breathing (kussmaul breathing), fruity breath odor (ripened apple smell...), abdominal pain, and coma. If not treated promptly, the disease can easily have serious consequences.

Unlike type 2 diabetes, type 1 diabetes is difficult to prevent and screen for. Dr. Truc recommends that people should not be subjective, thinking that "children do not get diabetes" or "diabetes is an old person's disease". People with suspected symptoms should go to the doctor for diagnosis.

Dinh Tien

* Patient name has been changed

Readers ask questions about diabetes here for doctors to answer

Source link