A case of severe ketoacidosis as the first clinical manifestation of type 2 diabetes mellitus in a youngster
Bibliographic record
Abstract
Type 2 diabetes (T2D) is a chronic condition caused by insulin resistance and relative insulin deficiency, leading to disrupted glucose homeostasis. Several genetic, behavioral, and socio-economic factors have been recognized as predisposing factors. The incidence of T2D in the pediatric population is increasing, paralleling the rise in obesity rates among youths. Early diagnosis and initiation of therapy are crucial to preventing or delaying long-term complications. We present the case of a 13-year-old Caucasian boy who presented with respiratory distress and altered consciousness, preceded by fever, cough, polyuria, and polydipsia. Blood gas analysis revealed metabolic acidosis (pH 7.1, Na 129.4 mmol/l, K 3.81 mmol/l, HCO3- 3.4 mmol/l, BE -23.65 mmol/l), ketonemia (4.8 mmol/l), and hyperglycemia (541 mg/dl), consistent with diabetic ketoacidosis. Further investigations, prompted by persistent respiratory distress and increased inflammatory markers, led to the diagnosis of complicated pneumonia. Based on clinical signs of insulin resistance (such as acanthosis nigricans), obesity (BMI 25.6 kg/m2), family history of T2D (father), and after excluding type 1 diabetes, monogenic, and other forms of diabetes, a diagnosis of T2D was eventually established. Following resolution of diabetic ketoacidosis, therapy with metformin was started, with prompt achievement of satisfactory glucose control. This case underscores the possible association between infections, accelerated metabolic decompensation, and severe diabetic ketoacidosis in individuals predisposed to T2D.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.007 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".