Association of Type- 1 Diabetes Mellitus and Sickle Cell Disease in Children: Case Series from Saudi Arabia

This case series aims to highlight a unique coexistence of two important diseases in children, sickle cell anemia and diabetes mellitus, which are relatively common in Saudi Arabia. Co-existence of the two diseases in the same patient is very rare, with only few cases reported in the literature. This is the first time to report more than 2 patients with this combination from one center. The involved 4 children are originally from the Southern and Eastern regions of Saudi Arabia representing both the African and Arab-Indian sickle gene haplotypes. The coexistence of the two diseases is not related to the sickle cell disease severity. It also can affect homo- and heterozygous forms of sickle cell disease at any age during childhood from infancy through adolescence. In sickle cell disease patients, Type-1 Diabetes can first present insidiously or as Diabetic Ketoacidosis. No clear explanation to the rarity of this combination is known so far. Diabetes mellitus should be considered in the differential diagnosis of cases with sickle cell disease experiencing abdominal pain, dehydration and acidosis. Further evaluation and comprehensive guidelines tailored for management of this condition are recommended.