Two case reports of severe pediatric hyperosmolar hyperglycemia and diabetic ketoacidosis accompanied with rhabdomyolysis and acute renal failure.

OBJECTIVE: This report describes two adolescent males in China who suffered from type 2 diabetes mellitus (T2DM) and hyperglycemic hyperosmolar syndrome (HHS) complicated by rhabdomyolysis (RM). After sufficient fluid administration, both patients recovered.
DESIGN: Case report.
RESULTS: These two obese patients suffered from T2DM, DKA and HHS. Because of insufficient fluid administration, these patients became aggravated and suffered from RM. After aggressive fluid resuscitation and insulin injection, the conditions of the two patients improved. Insulin administration was ceased after approximately 1 month of subcutaneous injections. The two patients attained good glucose control with diet management.
CONCLUSIONS: HHS is one of the most severe complications of T2DM. RM is a sign that the condition of a patient with HHS may worsen. Although management strategies are undefined, effective fluid infusion was shown to be helpful. Thus, the early signs of HHS and RM should be recognized so as to avoid severe complications.