Case report: Bilateral Cataracts and Diabetic Nephropathy as Complications of Type 1 Diabetes Mellitus in 14 Years Old Girl

Abstract

This case highlights the challenges of managing Type 1 Diabetes Mellitus (T1DM) in pediatric patients, particularly when poor glycemic control leads to serious complications such as diabetic nephropathy and early-onset cataracts. A 14-year-old female with a history of inconsistent insulin adherence, significant genetic predisposition, and limited family support presented with symptoms of malnutrition, visual impairment, and chronic hyperglycemia. Laboratory tests confirmed sustained hyperglycemia with an HbA1c of 11.2%, accompanied by early signs of nephropathy and advanced cataracts. Multidisciplinary management, including intensive insulin therapy, cataract surgery, nephrology consultation, and nutritional support, was implemented to stabilize her health. Despite the initial challenges of maintaining glycemic control, successful intervention through close endocrine and ophthalmologic coordination allowed for improved metabolic stability and vision restoration. This case underscores the necessity of a holistic approach to pediatric T1DM, addressing not only glycemic management but also education and psychosocial support. Long-term follow-up and preventive care remain crucial to optimize outcomes and prevent further complications, with an emphasis on continuous patient and family education to ensure adherence. This case advocates for an early, structured intervention strategy to improve the quality of life and mitigate the risks of T1DM complications in the pediatric population.