Robert Kelly

Type 1 diabetes mellitus (T1DM) can complicate recovery after mild traumatic brain injury (mTBI) by mimicking post-concussive symptoms. This case details the recovery of a 17-year-old female with T1DM who sustained an mTBI and lumbar spine fractures following a motor vehicle collision. Post-traumatic amnesia, short-term memory deficits, and impaired glucose regulation complicated her recovery. Cognitive symptoms of mTBI, such as working memory and attention deficits, can be worsened by nocturnal hypoglycemia, increasing the risk of poor glycemic control due to challenges with dietary and insulin management. Additionally, mTBI symptoms, such as headache and irritability, can overlap with hypoglycemia. At her one-week Physical Medicine and Rehabilitation (PM&R) follow-up, she reported persistent daily headaches, fatigue, neck pain, and nightly glucose readings in the 40s. In addition to standard concussion follow-up, the primary team coordinated a same-day evaluation by pediatric endocrinology, allowing real-time insulin adjustment in the clinic. With interdisciplinary management, the patient returned to her pre-injury cognitive baseline, her headaches improved, and her glucose levels stabilized. Misattributing symptoms to either mTBI or hypoglycemia can delay targeted treatment for both conditions, leading to worse functional outcomes and a prolonged rehabilitation course. This case highlights the importance of glycemic monitoring and team-based management in adolescents with T1DM recovering from concussion. It also illustrates the absence of standardized management strategies for adolescents with concurrent mTBI and T1DM.

The Next Chapter Starts Now — book, workbook, and digital edition by Bobby Kelly Phoenix Strategist Bobby Kelly — who once trained President George W.

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