Abstract
Fulminant Type 1 diabetes is a subtype of Type 1 diabetes characterized by (1) abrupt onset of diabetes, (2) very short duration of hyperglycaemia with mildly elevated HbA(1c) (< 69 mmol/mol, 8.5%), (3) rapid progression to diabetic ketoacidosis, (4) very low C-peptide level, and (5) often associated with elevated serum pancreatic enzymes, and absence of diabetes-related autoantibodies. We encountered a case of fulminant Type 1 diabetes that developed with an initial manifestation of the insulin autoimmune syndrome and rapidly progressed to diabetic ketoacidosis during pregnancy. A 31-year-old Korean woman presented with recurrent sudden onset of sweating and change of consciousness during sleep at 19 weeks gestation. During a 72-h fasting test, hypoglycaemia (1.72 mmol/l) occurred at 4 h after the start of the test. At that time, there was a high insulin level (370.2 μU/ml), a paradoxically low C-peptide level (0.01 nmol/l) and a positive insulin autoantibody test. An oral glucose tolerance test revealed postprandial hyperglycaemia. She was initially diagnosed as the insulin autoimmune syndrome. On the day 5 of admission, she developed diabetic ketoacidosis. Her HbA(1c) was 62 mmol/mol (7.8%). The rapid progression of diabetic...Continue Reading
References
Feb 3, 2000·The New England Journal of Medicine·A ImagawaY Matsuzawa
Jun 3, 2000·Annual Review of Immunology·A L Mellor, D H Munn
Apr 30, 2003·Diabetes Care·Tomoatsu NakamuraShun Ishibashi
Jun 14, 2003·Endocrine Journal·Taisuke Iwaoka
Jul 29, 2003·Diabetes Care·Akihisa ImagawaHideichi Makino
Jul 28, 2004·Diabetes Care·Shoichiro TanakaTetsuro Kobayashi
Sep 28, 2004·Diabetes·Satoshi MuraoHaruhiko Osawa
Nov 1, 2005·Internal Medicine·Kazumi Katsumata, Kazuo Katsumata
Nov 10, 2005·The Journal of Clinical Endocrinology and Metabolism·I ShimizuT Hanafusa
Jan 20, 2006·Journal of Thrombosis and Haemostasis : JTH·S MiyakisS A Krilis
Nov 30, 2006·Diabetes Care·Ashok BalasubramanyamMario R Maldonado
Dec 21, 2006·Nature Clinical Practice. Endocrinology & Metabolism·Toshiaki Hanafusa, Akihisa Imagawa
May 10, 2007·The Review of Diabetic Studies : RDS·Akihisa Imagawa, Toshiaki Hanafusa
Aug 29, 2007·Diabetologia·Y M ChoK S Park
May 4, 2011·Diabetes & Metabolism Journal·Suk ChonYoung Seol Kim
Citations
Jan 25, 2014·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·A MelvilleW Yoong
Aug 1, 2014·Diabetic Medicine : a Journal of the British Diabetic Association·M PhilipponB Delenne
Oct 25, 2014·PloS One·Mami ShimizuKoichi Yokono
Mar 31, 2020·Diabetes/metabolism Research and Reviews·Shuoming LuoZhiguang Zhou
Jan 1, 2021·The Journal of Clinical Endocrinology and Metabolism·He LiuYuxiu Li