An Unusual Case of Fulminant Type 1 Diabetes during the Second Trimester of Pregnancy

Okuda, Takahiko; Yamashita, Sadao; Ogino, Yukiko; Kataoka, Hideki; Kitawaki, Jo

doi:10.1155/2014/968547

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…In addition, only Graves disease was transient, whereas T1D remained permanent. Thus, it shows etiological differences between these 2 autoimmune diseases . Around 34.0% of patients displayed low titres of autoantibodies against 1 or more autoantigens.…”

Section: Clinical Characteristicsmentioning

confidence: 99%

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Recent findings on fulminant type 1 diabetes

Liu

Zeng

Sang

et al. 2017

Diabetes Metabolism Res

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SummaryFulminant type 1 diabetes (fT1D) is a new subtype of type 1 diabetes proposed by Imagawa in 2000. It is a clinical syndrome characterized by a markedly rapid and almost complete destruction of pancreatic β cells. Metabolic derangement is more severe in this subtype than in autoimmune type 1 diabetes. The incidence of fT1D is associated with HLA DRB1*04:05DQB1*04:01; both innate and acquired immune disorders might contribute to the development of fT1D. The presence of specific innate immune responses to enterovirus infection connected with enhanced adaptive immune pathways responsible for aggressive β cell toxicity in fT1D. The process of β cell destruction is extremely rapid in fT1D, and the insulin secretary capacity rarely recovers after the onset. The serum glycated albumin to glycated haemoglobin ratio is significantly higher in fT1D; a cut-off value of 3.2 for serum glycated albumin to glycated haemoglobin ratio yielded 97% sensitivity and 98% specificity for differentiating fT1D from type 2 diabetes. Fulminant type 1 diabetes is associated with pregnancy. This article also updates the diagnostic criteria for fT1D by the Japanese Diabetes Association in 2012.KEYWORDS enteroviruses, fulminant type 1 diabetes, human leukocyte antigen, immunity

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Section: Clinical Characteristicsmentioning

confidence: 99%

“…Thus, it shows etiological differences between these 2 autoimmune diseases. 34 Around 34.0% of patients displayed low titres of autoantibodies against 1 or more autoantigens.…”

Section: Association With Pregnancymentioning

confidence: 99%

Recent findings on fulminant type 1 diabetes

Liu

Zeng

Sang

et al. 2017

Diabetes Metabolism Res

View full text Add to dashboard Cite

show abstract

“…Insulin glargine is maintained at 10 units per day. Her In 2014, a 34-year-old pregnant (24 weeks) woman in Japan presented with nausea without any special medical history [9]. Ultrasound examination showed fetal heart rate and movement in nor- In Korea in 2016, a 32-week-pregnant woman presented with nausea and abdominal discomfort [11].…”

Section: Case Reportmentioning

confidence: 99%

Fulminant Type 1 Diabetes with Robust Recovery in Insulin Secretion in a Pregnant Woman as an Initial Manifestation of Third-Trimester Intrauterine Fetal Death

Seo

Han

Jeong

et al. 2017

Soonchunhyang Med Sci

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Fulminant type 1 diabetes mellitus (FT1DM) is a clinical entity in which the process of beta-cell destruction and subsequent progression of hyperglycemia and ketoacidosis are extremely rapid. A 34-year-old woman without any known risk factor for diabetes mellitus experienced a sudden stillbirth at 30 weeks of gestation. She had normal oral glucose tolerance test during pregnancy. Her blood glucose level was 974 mg/dL. Her urine test for ketone bodies was positive. Her hemoglobin A1c level (6.8%) was near normal range at the first emergency room visit. These findings suggested a very recent onset of diabetes mellitus. Her serum C-peptide level was very low. Islet-related autoantibodies were undetectable. Her clinical course, biochemical, and immunological profiles were consistent with FT1DM. After fluid and insulin based management, beta-cell was rescued with insulin therapy during the evolution of FT1D. At 10 days after admission, maintenance dose of insulin was just 8 unit of insulin once daily. This is the first case of FT1DM with robust recovery in insulin secretion in a pregnant woman who had an initial manifestation of 3rd-trimester intrauterine fetal death in Korea.

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An Unusual Case of Fulminant Type 1 Diabetes during the Second Trimester of Pregnancy

Cited by 2 publications

References 19 publications

Recent findings on fulminant type 1 diabetes

Recent findings on fulminant type 1 diabetes

Fulminant Type 1 Diabetes with Robust Recovery in Insulin Secretion in a Pregnant Woman as an Initial Manifestation of Third-Trimester Intrauterine Fetal Death

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