Po1534 Secondary Diabetes – A Case Report

Ljiljana Markovi´c1 e Branka Šoški´c1
1Health centre, New Belgrade
Introduction: Diabetes is the worldwide expansion of the epidemic and its share in it has a secondary diabetes.
Case report: 41-year-old man appears to his doctor for a severe pain in the upper abdomen. The pain is felt in the morning after late and lavish dinner. He denies other symptoms. He denies using drugs, chemicals, alcohol, he’s not a smoker, but has long stressed. He hasn’t been to a doctor because he thought he was completely healthy. Family history is negative in terms of chronic diseases and cancer. He is administrative worker, obese. The pain is getting stronger and he barely speaks. He gives the impression of a critically ill patient. The abdomen was painful on palpation diffusely sensitive. TA 150/90 EKG, pulmonary et cor auscultation, neat. He was sent to the lab immediately but due to hyperlipidaemia serum not been worked the required analysis. The pain is in the form of bands spread across the back and became almost unbearable, superficial breathing and was immediately transported to the hospital with suspected acute pancreatitis. On admission is made EHO abdomen and then the CT which showed the development of necrosis in the pancreas. Only after four days, they were able to measure the levels of triglycerides, which amounted to 93.6 mmol / l, cholesterol, glucose, transaminases and bilirubin were elevated twice. With adequate conservative therapy condition improved and infiltrate disappeared. He lost 12 kg weight. Laboratory findings, except triglyceride of 5.2 mmol / l, were satisfactory. Six months is a without symptoms, laboratory clean only mildly elevated triglycerides. Suddenly, abdominal pain recurring, so he was again hospitalized. Triglycerides are 43.5, 14.2 cholesterol, glucose 24.7 mmol / l, C-peptide of 0,017 nmol / l, 14.7% HbA1c. He was discharged with a diagnosis of secondary diabetes arising after acute pancreatitis. Fenofibrate and intensified insulin therapy were introduced, as well as lifestyle changes.
Conclusion: For each occurrence of higher values of triglycerides is often necessary to control glycaemia and think of developing diabetes.
Diabetes, secondary, acute pancreatitis