Association of Type- 1 Diabetes Mellitus and Sickle Cell Disease in Children: Case Series from Saudi Arabia
Journal of Advances in Medicine and Medical Research,
This case series aims to highlight a unique coexistence of two important diseases in children, sickle cell anemia and diabetes mellitus, which are relatively common in Saudi Arabia. Co-existence of the two diseases in the same patient is very rare, with only few cases reported in the literature. This is the first time to report more than 2 patients with this combination from one center. The involved 4 children are originally from the Southern and Eastern regions of Saudi Arabia representing both the African and Arab-Indian sickle gene haplotypes. The coexistence of the two diseases is not related to the sickle cell disease severity. It also can affect homo- and heterozygous forms of sickle cell disease at any age during childhood from infancy through adolescence. In sickle cell disease patients, Type-1 Diabetes can first present insidiously or as Diabetic Ketoacidosis. No clear explanation to the rarity of this combination is known so far. Diabetes mellitus should be considered in the differential diagnosis of cases with sickle cell disease experiencing abdominal pain, dehydration and acidosis. Further evaluation and comprehensive guidelines tailored for management of this condition are recommended.
- Sickle cell disease
- Type-1 diabetes
- diabetic ketoacidosis
- Saudi Children
How to Cite
Jastaniah W. Epidemiology of sickle cell disease in Saudi Arabia." Annals of Saudi Medicine 2011;31(3):289-293.
Al-Ali AK, Alsulaiman A, Alfarhan M, Safaya S, Vatte CB, Albuali WM, et al. Sickle cell disease in the Eastern Province of Saudi Arabia: Clinical and laboratory features. Am J Hematol. 2021;96(4):E117-E121.
Goyal R, Jialal I. Diabetes Mellitus Type 2 [Internet]. StatPearls Publishing January 2022 [cited April 2022].
Al-Hayek AA, et al. Assessment of health-related quality of life among adolescents with type 1 diabetes mellitus in Saudi Arabia." Saudi Med J. 2014;35(7):712-717.
Triplett G, Eichold S. Concurrent diabetes mellitus and sickle cell disease. Diabetes Care. 1979;2(3):327-8.
Reid HL, Photiades DP, Oli JM, Kaine W. Concurrent sickle cell disease and diabetes mellitus. Trop Geogr Med. 1988; 40(3):201-4.
Morrison JC, Schneider JM, Kraaus AP and Kitabchi AE. The prevalence of diabetes mellitus in sickle cell haemoglobinopathies. J Clin Endo Met. 1979; 48: 192-195.
Shoar Z, Rezvani G, De Luca F. Type 1 diabetes mellitus in a patient with homozygous sickle cell anemia. J Pediatr Endocrinol Metab. 2013;26(11-12):1205-7.
Jarrett OO, Olorundare EI. Type 1 diabetes mellitus in a known sickle cell anaemia patient: a rare combination in Nigeria. Afr J Med Med Sci. 2014;43(2):177-81.
Mohapatra MK. Type 1 diabetes mellitus in homozygous sickle cell anaemia. J Assoc Physicians India. 2005;53:895-6
Adekile AD, Jegenda AO. Juvenile onset diabetes mellitus in a sickle cell anaemia patient. East Afr Med J. 1990;67: 591-3.
Onyiriuka AN, Odunvbun ME and Ento IG. Diabetic Ketoacidosis in Two Nigerian Adolescents withHomozygous Sickle Cell Anaemia. Br J Med Med Res 2014;4(22): 4004–4010.
Ibrahim N, Lugga AS, Ibrahim OR. Diabetic-ketoacidosis in a nine-year-old child with homozygous sickle cell anaemia: a rare case report. Pan Afr Med J. 2019; 33:7.
Alhagamhmad M , Alhassony A, ElShiky A, Elarwah A, Alougly S, Elbrgathy S, et al. Concurrent Sickle Cell Anemia and Diabetes Mellitus with Ketosis in a Libyan Toddler: First National Report and Youngest Case Study. Asian Journal of Pediatric Research. 2020;3 (4):15-19
Reid HL, Ene MD, Photiades DP, Famodu AA. Insulin-dependent diabetes mellitus in homozygous sickle-cell anaemia. Trop Geogr Med. 1990;42(2):172-3.
ALQASSEM SM, Al-matary AM, Al-Zaazaai AA. The Concurrence of Sickle Cell Anemia with Diabetes Mellitus Type I and Complications (Nephropathy and Priapism). Int J Endocrinol Metab Disord. 2020;6(2):dx
McLean A, Wright F, deJong N, Skinner S, Loughlin CE, Levenson A, Carden MA. Hemoglobin A1c and fructosamine correlate in a patient with sickle cell disease and diabetes on chronic transfusion therapy. Pediatr Blood Cancer. 2020;67(9):e28499.
Warncke K, Konrad K, Kohne E, Hammer E, Ohlenschläger U, Herrlinger S, et al. Diabetes in Patients with ß-thalassemia or other Hemoglobinopathies - Analysis from the DPV Database. Klin Padiatr. 2016; 228(6-07):307-312.
Mohamed AA, Al-Qurashi F, Whitford DL. Does Sickle Cell Disease Protect Against Diabetes Mellitus?: Cross-sectional study. Sultan Qaboos Univ Med J. 2015;15 (1):e116-9.
Prusty B, Soren T, Choudhury A, Biswal R, Pradhan DK, Thatoi PK. Sickle cell disease prevents diabetes mellitus occurrence: A hospital based cross-sectional study. J Family Med Prim Care. 2019;8(2):361- 364.
Abraham EC, Stallings M, Cameron BF, Huisman TH. Minor hemoglobins in sickle-cell heterozygotes and homozygotes with and without diabetes. Biochim Biophys Acta. 1980;625(1):109-17.
Quinn CT, Rogers ZR, Buchanan GR. Survival of children with sickle cell disease. Blood. 2004;103(11):4023-7.
Sheehan AG, Machida H, Butzner JD. Acute pancreatitis in a child with sickle cell anemia. J Natl Med Assoc. 1993;85(1):70-2.
Ford ES, Cogswell ME. Diabetes and serum ferritin concentration among U.S. adults. Diabetes Care. 1999;22(12):1978-83.
Fernández-Real JM, López-Bermejo A, Ricart W. Cross-talk between iron metabolism and diabetes. Diabetes. 2002; 51(8):2348-54.
Abstract View: 87 times
PDF Download: 207 times