Type 2 diabetes mellitus: An unusual association with Down's syndrome
A 26-year-old female patient with a BMI of 33.4 kg/m2 with strong family history of DM were admitted in the in-patient Department of Endocrinology, Medwin Hospital for proper control of hyperglycemia. She gave a history of polyuria, but denied any weight loss. Physical examination revealed features of DS (short stature, obesity, brachycephaly, gynecomastia, protruding tongue, simian crease, pot belly, short neck and acanthosis nigricans, wide occipital region with characteristic small eyes). The laboratory evaluation revealed fasting and postprandial sugar levels as 175 mg/dl and 240 mg/dl, respectively HbA1c of 8.9%. Urine was negative for ketones. His fasting and stimulated C-peptide levels were 1.4 pmol/ml and 2.5 pmol/ml with negative GAD-antibody test (4.1 IU/ml). Other investigations were within normal limits. Glycemic control was achieved with gliclazide 40 mg with metformin 500 mg twice daily.