ABSTRACT
Myxedema coma (MC) is a potentially fatal complication of hypothyroidism, with a high mortality rate. It is a clinically diagnosed condition, where the symptoms are related to decreased metabolic effects due to low active thyroid hormones. This case report highlights a severe case of MC, despite the thyroid stimulating hormone (TSH) being normal and the free thyroxine (FT4) being very mildly decreased.
ABSTRACT
Since 2019, COVID-19 has plagued the world with its unfortunate death toll; however, with the introduction of multiple COVID vaccines, mortality and morbidity rates have severely declined. There have been misconceptions surrounding these vaccines, and at the same time, many documented conditions precipitated by the vaccines. This case highlights a speculated relationship between new-onset Latent Autoimmune Diabetes in Adults (LADA) (presenting with diabetic ketoacidosis) and the COVID-19 vaccine. There have been articles suggesting the precipitation of diabetic ketoacidosis /hyperosmolar hyperglycemic syndrome, as well as new-onset diabetes mellitus (DM) with the COVID-19 vaccines but no documented link between LADA and the vaccine. The endpoint of this case is not only to highlight a newfound side-effect of the vaccine but also to urge primary care providers and physicians to closely monitor glucose levels and patient's A1C after vaccine administration to prevent the formation of these hyperglycemic crises, as well as to consider autoimmune conditions in the differential diagnosis post-vaccination.
ABSTRACT
Diabetic ketoacidosis (DKA) is a triad of uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketone concentration. It is a well-known manifestation of type 1 diabetes mellitus (T1DM). However, it can also be the first presentation of type 2 diabetes mellitus (T2DM). This subtype of diabetes shares the characteristics of both T1DM and T2DM and is called 'Flatbush diabetes,' also known as 'ketosis-prone T2DM.' This article highlights the importance of early identification of ketosis-prone T2DM (KPD). We describe two cases of African American men with no past medical histories who presented with unproved DKA as the first presentation of T2DM requiring initial intensive insulin therapy, which was gradually withdrawn with the addition of metformin. Both patients are currently insulin independent for more than 15 months. It is an essential clinical entity to recognize as insulin independence positively impacts the quality of life and decreases the economic burden on the health care system.