A Child With Edematous Malnutrition-Modulated Diabetes Mellitus: An Uncommon Ailment With Unusual Presentation and Management—Case Report

The “double burden of malnutrition” refers to the simultaneous occurrence of undernutrition and overnutrition in the same population over the course of a lifetime. Both chronic undernutrition and obesity have been linked to diabetes mellitus (DM); the former is more prevalent in developing countries and can result in malnutrition-modulated diabetes mellitus (MMDM). This case study aimed to educate medical practitioners in developing and underdeveloped countries on how to treat diabetes mellitus and malnutrition. We came across a 10-year-old girl presented with signs and symptoms of edematous malnutrition and ketone resistant diabetes mellitus. Treated and discharged after spending 45 days in the hospital with higher dose of insulin, 2.8 IU/kg/day while Formula-75 malnutrition rehabilitation was implemented side to side. Lastly, we propose and conclude that efficient demand-based insulin management, and nutritional rehabilitation based on WHO malnutrition and diabetes diet guidelines for daily energy requirements are essential for MMDM. In our case, the weight gain that came from nutritional rehabilitation over time had no effect on the amount of insulin she needed, which defies current knowledge and necessitates further research.