Case study: undiagnosed diabetic child presented with paretic noncomitant esotropia

The prevalence of type II diabetes in adults is increasing. Superimposed on that are the recent reports of the emerging problem of type II diabetes in children and adolescents. Paretic [noncomitant] esotropia, usually a result of palsy of the abducens nerve is most often seen in adults who have had cerebrovascular accidents or diabetes due to infarction, but it is rarely reported in children. It is of sudden onset and the prognosis is good since most patients recover after a period of weeks to months. A case of undiagnosed diabetic child who presented to primary health care clinic with sudden onset of abducent nerve paresis is described with the main objective of raising the awareness of primary care physician about the increasing prevalence of type II diabetes in children and their unusual presentations. The patient was very obese [BMI = 30.5] with RBS of more than 22 mmol/L and marked glucosuria, with no evidence of ketosis