A Case of Fulminant Type 1 Diabetes Mellitus in an Elderly Patient

Seung Min Woo; Seung Hyun Hong; Sung Yun Lee; Su Heui Lee; Duc Ky Lee; Sae Jeong Yang

doi:10.4093/jkd.2015.16.3.225

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Woo, Hong, Lee, Lee, Lee, and Yang: A Case of Fulminant Type 1 Diabetes Mellitus in an Elderly Patient

Case Report

J Korean Diabetes 2015;16(3):225-229.

Published online: 10 January 2015

DOI: https://doi.org/10.4093/jkd.2015.16.3.225

A Case of Fulminant Type 1 Diabetes Mellitus in an Elderly Patient

Seung Min Woo, Seung Hyun Hong, Sung Yun Lee, Su Heui Lee, Duc Ky Lee, Sae Jeong Yang

Departments of Internal Medicine, Daerim Saint Mary's Hospital, Seoul, Korea

Corresponding author: Sae Jeong Yang Departments of Internal Medicine, Daerim Saint Mary's Hospital, 657 Siheung-daero, Yeongdeungpo-gu, Seoul 07442, Korea, E-mail: yangsj1977@naver.com

Received 19 March 2015 Accepted 30 March 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Insulin deficiency due to destruction of pancreatic β-cells is a typical characteristic of type 1 diabetes mellitus (DM). In 2000 Imagawa proposed a novel diagnostic model defining “fulminant type 1 DM” as developing rapidly without any evidence of autoimmunity, and ever since there have been many reports regarding the matter in Japan. In 2004, the first fulminant type 1 diabetes case was reported in Korea; however, there have been few reports since then. We present a case of a 60-year-old man who suffered from excessive thirst and polyuria after myalgia. Laboratory findings revealed a high blood glucose level and evidence of diabetic ketoacidosis, but the HbA1c level was within the normal range. The serum C-peptide level was very low and antibodies to glutamic acid decarboxylase were negative. These findings suggested fulminant type 1 diabetes. This patient has shown improvement in symptoms and examination results without complications after being treated with insulin therapy with hydration, throughout 6-months follow-up period.

Keywords: Diabetes mellitus, Diabetic ketoacidosis, Type 1

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