[A case of fulminant type 1 diabetes mellitus in an elderly patient who developed cardiopulmonary arrest from diabetic ketoacidosis and whose imaging course was monitored].

Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
Yasunari Yoshida, Tatuya Fujikawa

Abstract

A 71-year-old man with a history of hypertension and nephrosclerosis visited a primary care doctor for a regular visit. After a few days of vomiting and diarrhea, gastroenteritis was suspected and he was prescribed medication for these symptoms by his previous doctor. The next morning, he visited our hospital complaining of malaise and abdominal distention.The patient's blood glucose level was 1,385 mg/dL, his arterial blood pH was 6.885 (followed by an elevated serum ketone level), and hyperkinesis from diabetic ketoacidosis (DKA) was observed. The patient had experienced cardiopulmonary arrest, likely due to ventricular fibrillation. After cardiopulmonary resuscitation, the patient was admitted to hospital and treated for DKA. The urinary and serum C-peptide levels were below the limit of sensitivity, and anti-glutamic acid decarboxylase antibody and anti-insulinoma-associated antigen-2 antibody were not detected in the serum. These findings were consistent with a diagnosis of fulminant type 1 diabetes mellitus. We herein report a rare case of resuscitation in an elderly patient with fulminant-onset type 1 diabetes mellitus. We carefully observed the imaging history of the patient with great interest.

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