Authors: Oluwayemi I.O, Ajite A.B, Babatola A.O, Adeniyi A.T, Komolafe A.K, Adebisi A.O, Fasanmi A.S.
Background: The incidence of type 1 Diabetes Mellitus (DM) in children is increasing globally on yearly basis and lack of access to insulin remains the most common cause of death.
Case report: We present a 12-year-old prepubertal female vagrant who was brought for medical attention by Ekiti State Government officials. She presented with 4-year history of polyuria, polyphagia, weight loss and secondary enuresis. She was chronically ill looking, very weak, had a very low weight of 21kg (< 5th percentile), a low-normal height of 140cm (between 10th and 5th percentile). An assessment of Type 1 diabetes mellitus with chronic malnutrition was made. The random blood glucose (RBG) at presentation was unrecordably high and had glycosuria. The patient was resuscitated with normal saline for the first 2 hours after which insulin infusion was commenced at 0.1IU/kg/hour and later subcutaneous insulin. She made remarkable improvement before discharge to the Government transition home.
Conclusion: Chronic malnutrition is an uncommon presentation of type 1 DM in adolescents. Poverty and family conflict was a contributing factor to patient’s chronic malnutrition and vagrancy. Public-private partnership and multidisciplinary approaches are vital for effective management of DM among children and adolescents in developing countries.
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