A case of type II diabetes of early onset presenting with malignant diabetic microangiopathy at diagnosis

ABSTRACT

In 1987 O'Rahilly described a distinct clinical and genetic syndrome called type II diabetes of early onset (13). Different from Maturity Onset Diabetes of the Young (MODY), that is consistent with autossomal dominant inheritance, this group of patients may have inherited a diabetogenic gene or genes from both parents. Also, in contrast with classical type II diabetes, this syndrome affects mainly younger subjects and has a greater prevalence of severe diabetic microangiopathy. In this paper, we report a 25 year old patient who presented with clinical nephropathy and proliferative retiopathy at the time of diabetes diagnosis. Her mother and a paternal aunt had type II diabetes. Her glicemíc control did not require insulin administration and despite panphotocoagulation and antihypertensive therapy she became blind due to retinal detachment and progressed to chronic renal insufficiency in a few months. To our knowledge this is the first report of an young non-insulin dependent diabetic patient in whom clinical diabetes arose together with severe microangiopathy affecting the kidney and the retina simultaneously. We should call attention to the early diagnosis of this type of diabetes in subjects at risk, in order to institute prompt therapeutic measures able to ameliorate the course of microvascular complications.