A patient with rapid metabolic deterioration mimicking the onset of fulminant type 1 diabetes during treatment for autoimmune type 1 diabetes

Junpei Yamamoto, Keizo Kaneko, Kei Takahashi, Chihiro Satake, Uiko Tsunoda, Hiroko Kohno, Shojiro Sawada, Yutaka Hasegawa, Kenji Uno, Junta Imai, Tetsuya Yamada, Yasushi Ishigaki, Yoshitomo Oka, Hideki Katagiri

研究成果: Article査読

抄録

A 55-year-old man, recognized as having impaired glucose tolerance three years earlier, presented with an HbA1c (JDS) of 11 %. Sulfonylurea plus α-glucosidase inhioitor treatment was started, resulting in a decrease in HbA1c to 6.6 % two months later. However, since GAD (glutamic acid decarboxylase) antibodies were positive, he was diagnosed as having autoimmune type 1 diabetes and his treatment regimen was switched to intensive insulin therapy. Ten U/day of insulin effectively controlled his metabolic state for about 40 days: preprandial SMBG (self-monitoring of blood glucose) levels were approximately 100 mg/dl. However, despite the absence of known triggers including dietary conditions, he developed sudden abdominal fullness, thirst and polyuria and preprandial SMBG levels rose rapidly to more than 300 mg/dl for ten days. On admission, though he had already started insulin therapy, clinical findings met the diagnostic criteria for fulminant type 1 diabetes. At the time of discharge, 36 U/day of insulin were needed for glycemic control. In this case, SMBG enabled us to demonstrate rapid metabolic deterioration, mimicking the onset of fulminant type 1 diabetes, despite good control of autoimmune type 1 diabetes.

本文言語English
ページ(範囲)122-128
ページ数7
ジャーナルJournal of the Japan Diabetes Society
55
2
出版ステータスPublished - 2012 2 1

ASJC Scopus subject areas

  • 内分泌学
  • 内科学
  • 内分泌学、糖尿病および代謝内科学

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