Diabetic lipemia in a newly diagnosed diabetes mellitus

More than 30% of newly discovered diabetic patients are presented with diabetic ketoacidosis and even coma at the onset. Diabetic ketoacidosis associated with lipemia is a rare and under reported entity in children. The patient reported is a 4 yearold boy who admitted to the hospital's emergency department with two weeks history of polyuria, polydipsia, weight loss, and complained of abdominal pain, vomiting, and lethargy. He was diagnosed with diabetes mellitus type 1. Upon the clinical examination, the patient showed moderate dehydration, shallow breathing (hyperventilating with Kussmaul breathing) with fruity acetone-smell. A blood sample was withdrawn from the patient that was milky lipemic in appearance. The patient was given intravenous hydration with normal saline fluid, and regular insulin infusion according to DKA rotocol. Few days after hospitalization, glycemic and lipid profile were normalized.