title: Acute necrotizing pancreatitis in an adolescent with type 2 diabetes.
abstract: OBJECTIVE
  The demographics of diabetes among adolescents are changing, with an increasing prevalence of type 2 diabetes. Since adolescents with type 2 diabetes are susceptible to the same complications that accompany type 2 diabetes in adults, pediatricians are now encountering new diagnosis entities.
  
  
  RESULTS
  A 16-year-old Hispanic male presented to the emergency room with new onset diabetes. Laboratory evaluation revealed the diagnosis of hyperglycemic hyperosmolar nonketotic state. Within the next 24 hours, the patient's clinical status deteriorated with multi organ failure, followed by asystole. At autopsy, the pancreas demonstrated acute necrotising pancreatitis. Hyperglycemic hyperosmolar nonketotic state is a life-threatening emergency among adults with type 2 diabetes, and is now occurring more frequently among adolescents. Acute pancreatitis should be considered as a precipitating event, particularly in those with severe hypertriglyceridemia.
  
  
  CONCLUSIONS
  This case illustrates the changing morbidity of diabetes in adolescents and the need to consider acute pancreatitis and hyperglycemic hyperosmolar nonketotic in adolescents with severe metabolic decompensation. Since hypertriglyceridemia is a known risk factor for acute pancreatitis, patients should be monitored, and treated as needed.
authors.affiliation: Pediatric Endocrinology and Diabetes, Sheba Medical Center, Ramat-Gan and Maccabi Juvenile Diabetes Center, Raanana, Israel. orithami@sheba.health.gov.il
authors.forename: Orit
authors.initials: O
authors.lastname: Pinhas-Hamiel
authors.forename: Steven D
authors.initials: SD
authors.lastname: Chernausek
authors.forename: Philip
authors.initials: P
authors.lastname: Zeitler
mesh_terms: D000293:Adolescent; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D017809:Fatal Outcome; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000453:epidemiology* / Q000473:pathology