Abstract
BACKGROUND: 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. CASE SUMMARY: 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. CONCLUSION: Rapid and multidisciplinary management of DKA, pancreatitis, and malaria led to a favorable and stable prognosis.