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All Journal Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Nobian Andre
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Health Professions Medicine & Pharmacology Public Health

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Diabetic Ketoacidosis as The First Manifestation of a Young Adult with Diabetes A Clinical Approach to Distinguish Different Types of Diabetes Mellitus M. Ikhsan Mokoagow; Anak Agung Arie Widiastuti; Jerry Nasarudin; Marina Epriliawati; Ida Ayu Made Kshanti; Nobian Andre; Adlina Hafidzati; Vania Tryanni
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 1 No. 1 (2024): InaJEMD Vol. 1, No. 1
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v1i1.2

Abstract

Diabetic ketoacidosis (DKA) is an acute metabolic complication of diabetes. While it most commonly occurs in type 1 diabetes (T1DM), DKA can also occur in other types of diabetes. Encountering a case of DKA prompts further evaluation to determine the type of diabetes and manage patients accordingly. To establish a diagnosis of the type of diabetes in a case with an unusual presentation of DKA through a clinical approach. A 30-year- old male presented to the emergency department with sudden dyspnea. Laboratory examinations showed a blood glucose level of 506 mg/dL, a blood ketone level of 2.6 mmol/L, and a bicarbonate level of 5 mEq/L. Hishemoglobin A1c was 15.3%. He had not been previously diagnosed with diabetes mellitus. Studies have shown overlapping clinical and biochemical parameters of DKA among various types of diabetes. Following life-saving management, further clinical and laboratory evaluations should be performed. Measurement of autoantibody titer (i.e.: autoantibodies against glutamic acid decarboxylase, islet antigen-2, zinc transporter 8, and insulin) and c-peptide levels might help determine the type of diabetes in this patient. Establishing the diagnosis of a certain type of diabetes in young adults can be challenging. Based on clinical profile, a presumptive diagnosis of autoimmune diabetes, particularly latent autoimmune diabetes in adults (LADA), was made in this patient.
Clinically Non-Functioning Pituitary Incidentaloma Presenting as Recurrent Episodes of Hypoglycemia Nobian Andre; Marco Vidor; James Marcus; Teddy Ervano
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 2 (2025): InaJEMD Vol. 2, No. 2
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v2i2.62

Abstract

A pituitary adenoma is a tumor originating from the adenohypophysis. Pituitary adenomas are mostly discovered incidentally during radiological examinations performed for other purposes. Not all pituitary adenomas are functional. Non-functioning adenomas often present with symptoms due to mass effect and pituitary hormone deficiency. This case report presents a case of a 56-year-old man with type 2 diabetes mellitus who had an accidental finding of pituitary macroadenoma without overt hormone hypersecretion symptoms, but experienced recurrent hypoglycemia. Further investigation revealed low cortisol and insulin like growth hormone-1 levels, suggesting a Houssay phenomenon that leads to ‘resolution’ of diabetes due to hypopituitarism. Even in patients without overt symptoms of hormone hypersecretion, the possibility of subtle hypopituitarism due to tumor-induced pituitary dysfunction should not be overlooked. Patients with pituitary adenomas require evaluation by a multidisciplinary team involving endocrinology, neurosurgery, and ophthalmology.
Co-Authors Adlina Hafidzati Anak Agung Arie Widiastuti Ida Ayu Made Kshanti James Marcus Jerry Nasarudin M. Ikhsan Mokoagow Marco Vidor Marina Epriliawati Teddy Ervano Vania Tryanni