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Introduction: Type 1 Diabetes Mellitus is one of the most prevalent chronic diseases in childhood and adolescence. Disease presentation is diverse, depending on the duration of symptoms and the age of onset. Case report: A 30-month-old child was referred to the Paediatric Outpatient Clinic for loss of cognitive and behavioural skills and stagnation of motor abilities occurring in the last six months, weight loss and polydipsia during the previous month. The child was diagnosed with inaugural type 1 Diabetes Mellitus without acidosis. Management of the disease, through glycaemic control with insulin therapy was associated with progressive improvement of the child’s neurodevelopment. Discussion/Conclusion: This case illustrates an unusual presentation of type 1 Diabetes. The mechanisms underlying acute neurological changes associated with type 1 Diabetes are not yet completely clarified. An efficient glycaemic control benefits an adequate neurodevelopment of children with Diabetes., NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, Vol 27, No 2 (2018)

Introduction: Type 1 Diabetes Mellitus is one of the most prevalent chronic diseases in childhood and adolescence. Disease presentation is diverse, depending on the duration of symptoms and the age of onset. Case report: A 30-month-old child was referred to the Paediatric Outpatient Clinic for loss of cognitive and behavioural skills and stagnation of motor abilities occurring in the last six months, weight loss and polydipsia during the previous month. The child was diagnosed with inaugural type 1 Diabetes Mellitus without acidosis. Management of the disease, through glycaemic control with insulin therapy was associated with progressive improvement of the child’s neurodevelopment. Discussion/Conclusion: This case illustrates an unusual presentation of type 1 Diabetes. The mechanisms underlying acute neurological changes associated with type 1 Diabetes are not yet completely clarified. An efficient glycaemic control benefits an adequate neurodevelopment of children with Diabetes. Introdução: A Diabetes Mellitus tipo 1 é uma das doenças crónicas mais prevalentes na infância e adolescência. A apresentação da doença é variável, dependendo da duração dos sintomas e da idade da criança. Caso Clínico: Os autores descrevem o caso de uma criança de 30 meses avaliada em consulta de Pediatria por perda de competências cognitivo-comportamentais e estagnação das aquisições motoras, tendo sido diagnosticada uma Diabetes Mellitus tipo 1 inaugural, sem acidose. Após a melhoria do controlo glicémico com a insulinoterapia, verificou-se uma normalização progressiva do neurodesenvolvimento da criança. Discussão/ Conclusão: Este caso ilustra uma apresentação incomum da Diabetes Mellitus tipo 1. A fisiopatologia das alterações neurológicas agudas associadas à Diabetes Mellitus tipo 1 ainda não está totalmente esclarecida. Um controlo glicémico eficaz é benéfico para o adequado neurodesenvolvimento das crianças com Diabetes.