Combined Sickle Cell Disease and Diabetes Mellitus Type One - First Reported Case in KSA.

Rehab Y AL-Ansari; Reema.Al Abdulqader; Leena Abdalla; Moutaz Osman

Volume : IX, Issue : V, May - 2020

Combined Sickle Cell Disease and Diabetes Mellitus Type One - First Reported Case in KSA.

Rehab Y Al Ansari, Reema. Al Abdulqader, Leena Abdalla, Moutaz Osman

Abstract :

Diabetes mellitus type one accounts for the two third of diabetes Mellitus in young population [1]. In the other hand, Sickle cell disease is a genetic disease with different haplotypes and geographic distributions [2]. Combination between diabetes type one and sickle cell disease is uncommon worldwide. For this rare combination this case is reported. Case report: This is a 16 years old dark skin female, a known case of sickle cell disease with frequent admissions to hospital as simple vaso-occlusive crisis in a form of generalized body ache. She was kept on oral folic acid 5mg once daily and analgesia in form of oral NSAID (non-steroidal anti-inflammatory drugs) and paracetamol at home. She has no previous surgery, no frequent transfusion and no iron overload. She had one attack of acute chest syndrome required exchange transfusion and since then she was kept on Hydroxyurea (She is taking 1 gm per day). Patient found to have multiple readings of high blood sugar for almost six months. Diagnosed as type 1 Diabetes mellitus at age of 14 years old based on Anti-GAD (Glutamic Acid Decarboxylase) antibodies. Started on insulin, basal and premeal. never presented with ketoacidosis although she presented several times with dehydration, upper respiratory tract infection, gastroenteritis and many times missing doses of insulin. She has family history of type 2 Diabetes mellitus in her father and her family. We are questioning if Sickle gene will protect her from ketoacidosis although she presented several times with clear precipitating factor for ketoacidosis. Conclusion; In conclusion, both sickle cell disease and Diabetes Mellitus type one is common among young age population. The combination between the two diseases is not reported widely. Whether the presence of Sickle cell disease really protects from diabetes mellitus, generally, and diabetic ketoacidosis, specially, is an area requires further study.