Fulminant type 1 diabetes during pregnancy: A case report and review of the literature

Abstract

Fulminant type 1 diabetes, classified as a subtype of nonautoimmune type 1 diabetes, may result in severe complications for both mother and fetus due to the sudden onset of diabetic ketoacidosis. Little is known about the clinical features of pregnancy with fulminant type 1 diabetes. We present a case of fulminant type 1 diabetes during pregnancy, along with a review of the published literature. A 31-year-old Japanese woman presented with sudden onset of nausea and vomiting at 36 weeks' gestation and was provisionally diagnosed with acute gastroenteritis. She was referred to us for investigation of exaggerated general fatigue and intrauterine fetal death. Based on blood and urinary examinations, she was diagnosed with diabetic ketoacidosis, caused by fulminant type 1 diabetes. Although her ketoacidosis was improved, insulin therapy was needed. Awareness of this disease can lead to prompt diagnosis and treatment and consequently, improved maternal and fetal prognosis.

Fulminant type 1 diabetes linked with fetal death in utero

“…Our patient presented 48 hours after symptom onset with reported normal fetal movements; however, FDIU was diagnosed at time of presentation with anhydramnios suggesting an earlier demise. A study conducted in 200718 noted that of the 12 cases of FT1DM in pregnant women, only one case resulted in a live birth 19. The fetus was delivered within 24 hours of symptom onset in this patient.…”

An Unusual Case of Fulminant Type 1 Diabetes Developed during Puerperium

“…Diabetic ketoacidosis (DKA) and complete β-cell destruction occur within a short period of time. The disease is more likely to develop during the third trimester of pregnancy [ 1 , 2 ]. The disease has not been fully characterized.…”