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Updated 15 May 2015

What's your diagnosis? - Case 10: diabetic teenager with unusual signs and symptoms

Mrs V took her 15-year-old daughter, Miss V, to their family doctor for a check-up. Miss V was diagnosed with diabetes mellitus type I at age seven. During the course of the consultation some odd new information came to light. Put your medical caps on and solve our latest case in this week’s What’s your Diagnosis?

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Since Miss V’s diagnosis with diabetes it has been an uphill battle for the whole family, involving changes in diet and a number of serious hypoglycaemic episodes (where blood sugar drops to dangerously low levels).

Mrs V mentioned to the doctor that she is worried about her daughter’s deteriorating academic performance. Her daughter's teacher called Mrs V recently, expressing concern about Miss V’s attitude – often ignoring her when she speaks to her. Mrs V has also noted similar behaviour at home. Miss V often isolates herself her in her room, playing very loud music, which she refuses to turn down because she doesn’t think it is actually that loud. 

The teacher also mentioned that Miss V might be hyperactive because she often needs to go to the bathroom. Mrs V is not too concerned because she knows that her daughter drinks a lot of water.

Mrs V is quite aware of the dangers of diabetes as she educated herself about the disease when her daughter was diagnosed. She, for instance, regularly takes her daughter for eye testing. Miss V does wear glasses and recently had her prescription adjusted as her vision had deteriorated further.

On examination, the doctor found the following:

1.       Random blood glucose of 7.8

2.       Normal heart and lung and abdominal examination

3.       Urine test: a trace of glucose in very clear urine

One finding particularly concerned the doctor: on eye examination, he found what is known as a pale-pink optic disc. He decided to refer Miss V for further investigation as he is convinced there is more to her symptoms than just being an out-of-control teenager with diabetes.

What’s your diagnosis?

Clue: In medicine there is no such thing as a silly complaint and no coincidences. 

What’s your diagnosisJoin the guesswork on our Facebook page, or comment below. 

NOTE: Health24's on-site GP Dr Owen Wiese will reveal new cases on Thursdays. We'll post the answer with the story on Mondays, or you can get it via the Daily Tip – sign up here.

Previously on What's Your Diagnosis

What's your diagnosis? -  Case 1: vomiting and weight loss
What's your diagnosis? -  Case 2: eye pain
What's your diagnosis? -  Case 3: strange behaviour and a bullet in the back
What's your diagnosis? -  Case 4: seeing odd things
What's your diagnosis? - Case 5: mysterious lungs
What's your diagnosis? - Case 6: runner with seizures
What's your diagnosis? - Case 7: swollen knee
What's your diagnosis? - Case 8: bloody semen
What's your diagnosis? - Case 9: confusing neurological signs

 
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