title: Severe vulvovaginitis as a presenting problem of type 2 diabetes in adolescent girls: a case series.
abstract: This article describes the presentation of 4 adolescent girls who sought medical attention for severe vulvovaginitis and were subsequently found to have type 2 diabetes. Symptomatic vulvovaginitis is rare in adolescent girls, and its presence should alert health care providers to test for underlying hyperglycemia. These 4 girls represent 8.5% of the females with new-onset type 2 diabetes during a 3-year period (2007-2009). The 4 cases fulfilled the current Canadian Diabetes Association screening criteria for type 2 diabetes in youth, yet none of these girls had been screened. These cases highlight the need for better awareness of screening criteria for type 2 diabetes in adolescents. Consideration should be given in clinical practice guidelines to including the presence of unusual or severe infections as a risk factor for type 2 diabetes in youth.
authors.affiliation: Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada. jacqueline.curran@health.wa.gov.au
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Curran
authors.forename: Jenette
authors.initials: J
authors.lastname: Hayward
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sellers
authors.forename: Heather
authors.initials: H
authors.lastname: Dean
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D001786:Blood Glucose / Q000378:metabolism; D002181:Candidiasis, Vulvovaginal / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004927:Escherichia coli Infections / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage; D007657:Ketone Bodies / Q000097:blood; D009765:Obesity / Q000097:blood / Q000150:complications; D013290:Streptococcal Infections / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D013292:Streptococcus agalactiae; D014848:Vulvovaginitis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D007657:Ketone Bodies; C517652:hemoglobin A1c protein, human