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This 16 month old boy had insulin-dependent diabetes mellitus presenting with diabetic ketoacidosis (DKA) which is a serious condition. When he arrived at the ER, the physicians thought he has septic shock so he was intubated at the intensive care unit and was given lots of intravenous fluids.

Routine blood test showed that his sugar was 456 mg/dl (normal 80-120 mg/dl).

The respiratory symptom was from a viral bronchiolitis the triggered the diabetes mellitus that lead to DKA.

The physicians who took care of him at the ER was fooled initially because of his young age. Diabetes is uncommon under 24 months old.

The classic symptoms of diabetes mellitus are: frequent urination (polyuria), frequent drinking (polydipsia), and weight loss. These symptoms may last for about a month before diabetes is suspected. In young children, it is more difficult to diagnosis diabetes because it look like gastroenteritis.

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Leo Leonidas, MD, FAAP

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