NON-INSULIN-DEPENDENT DIABETES-MELLITUS - DIAGNOSTIC AND THERAPEUTIC CHALLENGES IN THE SEVERELY BURNED PATIENT - A CASE-REPORT

The purpose of this paper is to describe the management of a previousl y undiagnosed non-insulin-dependent diabetic patient with a severe bur n injury. The hyperglycaemia and glucose intolerance following burn in jury was complicated by the hyperglycaemia of diabetes mellitus. Intra venous insulin infusion monitored by hourly glucose levels was require d to manage this hyperglycaemia. During day 11 postburn injury, this p atient required 2104 units of insulin to control his hyperglycaemia. A ggressive detection and management of infections complemented by early debridement and coverage of the burn wound were other important consi derations in the management of this patient. The diagnosis of non-insu lin-dependent diabetes mellitus (NIDDM) was made after the patient rec overed from his burn injury. His rehabilitation programme has included primary prevention strategies for NIDDM that focus on health-improvin g behaviours such as improved diet, exercise, and weight control.