PMID- 25701831
OWN - NLM
STAT- MEDLINE
DCOM- 20160304
LR  - 20181113
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2015
DP  - 2015 Feb 20
TI  - Type 2 diabetes presenting with hyperglycaemic hyperosmolar state in an 
      adolescent renal transplant patient.
LID - 10.1136/bcr-2014-207124 [doi]
LID - bcr2014207124
AB  - Hyperglycaemic hyperosmolar state (HHS) is a life-threatening condition rarely 
      seen in paediatrics. It is becoming increasingly recognised with the growing 
      incidence of childhood type 2 diabetes mellitus (T2DM). We present a 16-year-old 
      boy with Bardet-Biedl syndrome, with comorbidities including chronic renal 
      impairment requiring renal transplant, isolated growth hormone (GH) deficiency 
      and obesity, who presented on routine follow-up with new onset T2DM and in HHS. 
      Investigations revealed hyperglycaemia (45.7 mmol/L), ketones of 0.1 mmol/L, pH 
      7.38 and osmolarity 311 mOsmol/kg. After acute management with fluid 
      resuscitation and intravenous insulin, he is now stable on metformin. He has lost 
      weight, renal function is stable and he has stopped GH therapy. We discuss the 
      dilemmas encountered in his long-term management due to his renal transplant and 
      comorbidities, and whether or not, given his significant T2DM risk, this case was 
      preventable or predictable.
CI  - 2015 BMJ Publishing Group Ltd.
FAU - Harrington, Francesca Ruth
AU  - Harrington FR
AD  - Department of Paediatrics, Royal United Hospital, Bath, Somerset, UK.
FAU - Wolfenden, Helen
AU  - Wolfenden H
AD  - Department of Paediatrics, Royal Berkshire Hospital, Reading, UK.
FAU - Makaya, Tafadzwa
AU  - Makaya T
AD  - Department of Diabetes & Endocrinology, Oxford Children's Hospital, Oxford, UK.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20150220
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Administration, Intravenous/methods
MH  - Adolescent
MH  - Bardet-Biedl Syndrome/*complications
MH  - Body Mass Index
MH  - Diabetes Mellitus, Type 2/complications/*diagnosis/therapy
MH  - Dwarfism, Pituitary/*complications
MH  - Fluid Therapy/methods
MH  - Humans
MH  - Hyperglycemic Hyperosmolar Nonketotic Coma/*diagnosis/etiology/therapy
MH  - Hypoglycemic Agents/administration & dosage
MH  - *Immunocompromised Host
MH  - Incidental Findings
MH  - Insulin/administration & dosage
MH  - *Kidney Transplantation
MH  - Male
MH  - Obesity/complications
MH  - Renal Insufficiency, Chronic/*complications/surgery
MH  - Risk Factors
MH  - Treatment Outcome
PMC - PMC4336874
EDAT- 2015/02/24 06:00
MHDA- 2016/03/05 06:00
PMCR- 2017/02/20
CRDT- 2015/02/22 06:00
PHST- 2015/02/22 06:00 [entrez]
PHST- 2015/02/24 06:00 [pubmed]
PHST- 2016/03/05 06:00 [medline]
PHST- 2017/02/20 00:00 [pmc-release]
AID - bcr-2014-207124 [pii]
AID - 10.1136/bcr-2014-207124 [doi]
PST - epublish
SO  - BMJ Case Rep. 2015 Feb 20;2015:bcr2014207124. doi: 10.1136/bcr-2014-207124.