# Diabetic Ketoacidosis Presenting as Abdominal Pain in a Two-Year-Old Female: A Case Report

## TL;DR

A two-year-old girl with undiagnosed type 1 diabetes presented with abdominal pain and was diagnosed with diabetic ketoacidosis, highlighting the importance of considering DKA in pediatric patients with similar symptoms.

## Contribution

This case report emphasizes the need to consider DKA as a potential diagnosis for pediatric patients presenting with abdominal pain.

## Key findings

- The patient had elevated glucose levels (500 mg/dL in urine and 533 mg/dL in blood) and an anion gap of 25, confirming DKA.
- The patient was diagnosed with type 1 diabetes mellitus and admitted to the PICU for treatment.
- Abdominal pain was the primary presenting symptom, which is atypical for DKA.

## Abstract

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes and can sometimes be the first indication of undiagnosed type 1 diabetes mellitus (T1DM). Our case presents a unique scenario in which a two-year-old female presented to her pediatrician with persistent abdominal pain, along with fatigue and tachypnea. On physical examination, she was mildly distressed, tachypneic, and utilized accessory muscles during respiration. Subsequent urinalysis indicated elevated glucose levels of 500 milligrams/deciliter (mg/dL). She was promptly referred to the emergency department to be treated for DKA. Upon arrival, the patient's glucose level was elevated at 533 mg/dL, with an anion gap of 25. She was stabilized and admitted to the pediatric intensive care unit (PICU) with a new diagnosis of T1DM with ketoacidosis. Given the emergent nature of DKA and the need for immediate treatment, physicians should consider DKA as a potential diagnosis for any pediatric patient presenting with abdominal pain.