Published online Aug 16, 2025. doi: 10.12998/wjcc.v13.i23.106321
Revised: April 14, 2025
Accepted: April 25, 2025
Published online: August 16, 2025
Processing time: 102 Days and 14 Hours
Type 1 diabetes is an autoimmune disease leading to insulin deficiency, and it is mainly diagnosed in young adults. One of the major acute complications of type 1 diabetes is diabetic ketoacidosis (DKA), which is a metabolic emergency that can be triggered by stress, infection, or poor blood glucose control. The association of DKA with conditions such as acute pancreatitis and malaria is rare and therefore represents a major diagnostic and therapeutic challenge.
A 20-year-old female was admitted to the emergency room for abdominal pelvic pain, fever, asthenia, polyuria, and polydipsia with a progressive deterioration of her state of consciousness. At admission, she was in a mild coma (Glasgow score: 9), had a fever of 38.5 °C, and had hyperglycemia (6 g/dL). The tests revealed severe DKA, hypertriglyceridemia, hyperamylasemia, and hyperlipasemia as well as malaria parasite density. The computed tomography scan confirmed acute stage E pancreatitis. The diagnosis was that of inaugural ketoacidosis of type 1 diabetes unbalanced by pancreatitis and malaria. Treatment included insulin therapy, rehydration, and antimalarial and analgesic treatment. After 10 days, the outcome was favorable with a normalization of the blood sugar, and an endocrine follow-up was recommend.
Rapid and multidisciplinary management of DKA, pancreatitis, and malaria led to a favorable and stable prognosis.
Core Tip: Type 1 diabetes is an autoimmune disease that can lead to serious metabolic disorders, electrolyte imbalances, and acute complications. Malaria impacts inflammation and metabolism and can aggravate diabetic ketoacidosis and electrolyte imbalances associated with type 1 diabetes, complicating clinical management of the patient. Prompt and targeted treatment is essential to avoid serious decompensation of the patient and ensure a favorable outcome. It is therefore essential to consider malaria as an aggravating factor when diagnosing and treating complications of type 1 diabetes.