M.C. Cubero Sobradosa, O. Martin Gordob, D. Agüero Orgazb
aPediatra.
CS Orcasitas.
Madrid.
Spain. bMedico de Familia.
CS Orcasitas.
Madrid.
Spain.
1.
After 8 hours of fasting glucose, the patient visited the health centre due to poor gain during the last month. A urine test showed glycosuria (300 mg/ 127).
No polyuria, polydipsia, vomiting, fever, or other symptoms were reported.
Controls of postprandial capillary glycemia were repeated and the patient was referred to a hospital for study.
Personal History
Controlled pregnancy, gestational diabetes mellitus diagnosed in the third trimester and controlled with diet.
Eutocic delivery.
Preterm newborn (PTNB) (35 + 5 s) with birth weight of 2260 g and length of 49 cm. Neonatal hyperbilirubinemia.
Exclusive breastfeeding for four months, after mixed breastfeeding.
At birth: anonychia in both index fingers and nail of the middle finger of the left hand with partial absence.
Full immunisation for your age.
Prophylaxis against rachytism with vitamin D3.
No known allergies to date.
Family history
Male, 37 years old, healthy; G3-A1-V2.
Gestational diabetes mellitus in the previous pregnancy; menarche at nine years; height 165 cm.
High baseline blood glucose (100-125 mg/dl), non-overweight; height 175 cm. Hermanastro (parental route) 12 years old, PTNB high for gestational age.
Hypertensive maternal grandmother.
Diabetic paternal grandmother treated with diet.
An important family history of hyperglycemia in the paternal branch: grandmother, three grandfather-uncles, three uncles and minors.
Complementary tests
- blood count: haemoglobin: 12.5 g/dl; platelets: 698 000/mm3; leukocytes: 16 700/mm3 (neutrophils: 24%, lymphocytes: 65.9%).
- Hepatorenal profile: normal; glucose: 120 mg/dl; sodium: 142 mEq/l; potassium: 4 mEq/dl.
Venous gas: ph: 7.45; bicarbonate: 23.2 mmol/l; pCO2: 32.8 mm Hg.
- Urine leakage: ph 6.5, density 1020; otherwise normal.
Normal sedation.
- Insulin: less than 2 mU/l, C-peptide: 0.49 ng/ml (normal values 0.5-2.0 ng/ml); glycated haemoglobin: 5.1%.
Normal thyroid hormones
Celiac disease antibodies negative.
Normal lipid profile.
Autoimmunity study of diabetes mellitus: anti-GAD65, A-antiinsulin, anti-IA2 negative and immunoglobulin D: 1 mg/dl.
Establishment
Weight of 6500 g (-2/-3 standard deviations [SD]); height of 67 cm (-1/-2 SD).
Good general condition, well hydrated and perfused; normal cardiopulmonary auscultation; normal abdomen.
Tanner stage I (T1-P1-A1); 2 ml Prader tests in bags.
Absence of nail in the index fingers of both hands and partial absence of nail from the third finger of the left hand.
Neurological and osteoarticular findings were normal.
Ev
During follow-up, the patient presented capillary glycemia controls ranging between 100 and 183 mg/dl, maintaining an excellent general condition at all times.
There was no glucosuria, ketonuria or polyuria-polydipsia at any time.
You have not required any treatment.
1.
Correspondence address: M.a Carmen Cubero Sobrados, kr_qb@hotmail.com
