Acute metabolic cataract as a first manifestation of diabetes mellitus in a 12-year-old girl

Excerpt

To the Editor: We report a case of juvenile cataract and Type 2 diabetes in a 26-year-old female (154 cm, 51 kg). A sibling of her mother had impaired glucose tolerance. Polydipsia and leg paresthesia were apparent in this patient with cataract since the age of 10, and she was diagnosed with diabetes at the age of 12. On her first visit, her intelligence and physical examination results were normal, except for bilateral cataracts (an unusual manifestation in a 12-year-old girl). Ptosis, ophthalmoplegia and hearing loss were not observed. Her fasting plasma glucose concentration was 25.3 mmol/l, and her HbA_1c was 20.1%. Other laboratory examination data were normal. She began intensive insulin treatment and 4 months later her HbA_1c rapidly decreased to 5.9%, and the leg paresthesia disappeared. She underwent successful bilateral cataract extraction with intraocular lens implantation. Four years later, she stopped insulin therapy and has been under excellent control (HbA_1c 6.0%) with oral hypoglycaemic agents, and she has been free of symptoms. …