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Case Reports
- A Case of Fulminant Type 1 Diabetes Mellitus with Human Leukocyte Antigen DR4-DQ4.
- Ye Ri So, Ja Won Koo, Young Hak Cho, You Cheol Hwang, Kyu Jeung Ahn, Ho Yeon Chung, In Kyung Jeong
- Endocrinol Metab. 2012;27(4):314-317. Published online December 20, 2012
- DOI: https://doi.org/10.3803/EnM.2012.27.4.314
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Abstract
PDF - The clinical characteristics of fulminant type 1 diabetes are abrupt onset of disease, very short (<1 week) duration of diabetic symptoms, ketoacidosis at diagnosis, negativity for islet-related autoantibodies, virtually no C-peptide secretion (fasting plasma C-peptide <0.3 ng/mL), a near normal hemoglobin A1c (HbA1c) level and an elevated serum pancreatic enzyme level. The pathogenesis has not yet been clarified, however the involvement of both genetic background and viral infections has been suggested. We reported a case of fulminant type 1 diabetes. A 37-year-old woman was admitted with stuporous consciousness to our hospital. Four days prior to the admission, she was hospitalized with the diagnosis of acute pancreatitis in another hospital, and at that time her glucose level was 79 mg/dL. Three days after the hospitalization, her state of consciousness became stuporous and she was transferred to our hospital. The laboratory results were as follows: pH 6.94, glucose 1,602 mg/dL, and HbA1c 5.5%. She was negative for islet-related autoantibodies and viral antibodies. HLA haplotypes were DRB1*04:05/*04:06, DQB1*03:02/*04:01 which might be a considerable risk allele for fulminant type 1 diabetes. She was diagnosed with fulminant type 1 diabetes, and has been treated with multiple component insulin regimens.
- A Case of Fulminant Type 1 Diabetes Mellitus Complicated with Ischemic Ileitis.
- Se Won Oh, Ju Ri Park, Yun Jeong Lee, Hee Yeong Kim, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Sin Gon Kim
- J Korean Endocr Soc. 2009;24(2):116-120. Published online June 1, 2009
- DOI: https://doi.org/10.3803/jkes.2009.24.2.116
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Abstract
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- Fulminant type 1 diabetes is characterized by diabetes with an abrupt onset, severe metabolic acidosis at diagnosis, a low HbA1c level and negativity for islet cell-related autoantibodies, and this illness has been classified as type 1B diabetes by the WHO. The prevalence of this disease is higher in Japan than any other country and recently, there have been an increasing number of such case reports in Korea. Genetic factors and environmental factors such as virus infection and an immune mechanism have been suggested as the mechanism of the pathophysiology, but this remains to be clarified.
- A Case of Hepatomegaly due to Diabetic Glycogenosis Reversed by Glycemic Control.
- Jina Park, Dae Hoon Song, Jong Suk Park, Joo Young Nam, Chul Sik Kim, Dol Mi Kim, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Hae Ryoung Kim, Chan Il Park
- J Korean Endocr Soc. 2004;19(2):223-228. Published online April 1, 2004
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Abstract
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- Diabetes mellitus is well known to be associated with various structural and functional liver abnormalities. If diabetic patients are accompanied by hepatomegaly or abnormal findings from a liver function test, the most common pathological findings are steatosis and glycogenosis. The steatosis is characterized by deposition of macrovesicular fat droplets in the hepatocytes, which is common in obese, type 2 diabetes mellitus. If macrovesicular steatosis is combined with mixed inflammatory infiltrate, without evidence of alcoholic hepatitis, the case could be diagnosed as nonalcoholic steatohepatitis (NASH). NASH has the possibility of progressing to cirrhosis. Secondary glycogenosis is common in uncontrolled type 1 diabetes mellitus, and is completely reversible. A 22-year-old male, with uncontrolled type 1 diabetes mellitus, was admitted with anorexia, nausea and right upper quadrant pain. Hepatomegaly and elevated aminotransferases were noted. He was diagnosed as diabetic glycogenosis using computed tomogram and liver biopsy. The hepato megaly and liver function test abnormalities were markedly improved with glycemic control
Original Article
- The Effects of Type 1 diabetes on the Metabolism and Density of Bone in Children.
- Sang Jun Lee, Dong Wook Lee, Hyun Dae Yoon, Kyu Chang Won, Hyoung Woo Lee, Yoon Jung Cho, Heung Sik Kim, Seung Beom Han, In Kyu Lee, Hee Ja Lee
- J Korean Endocr Soc. 2000;15(4-5):582-590. Published online January 1, 2001
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Abstract
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- BACKGROUND
The effects of type 1 diabetes mellitus on the metabolism and density of bone in children are still controversial. The aim of this study was to evaluate the effects of type 1 diabetes on markers of bone metaboism and BMD in children by analyzing BMI, HbA1c, biochemical markers, sex hormones, bone metabolism and BMD related factors. MRTHODS: We compared 36 patients (15 males, 21 females) with type 1 diabetes mellitus to 167 healthy children (84 males, 83 females) who lived in Taegu. We measured FBS, serum calcium, phosphorus, HbA1c, osteocalcin, testosterone and estradiol for analyzing the factors which influence on bone metabolism and BMD. BMD was measured at lumbar spine, femur and total body by DEXA. RESULTS: The BMI and serum level of osteocalcin were not different in both groups. Serum calcium level was significantly lower in the diabetic group than that of control group. BMD had no difference in both groups. There was no correlation between BMD and glycemic control (HbA1c) or duration of diabetes. There was good correlation (r=0.78, p<0.01) between serum testosterone level and BMD in male patient group. There was negative correlation (r=-0.4) between serum osteocalcin level and BMD. There was significant correlation (male: r=0.76, female: r=0.66) between lean body mass and BMD in both group. CONCLUSION: The BMD was not decreased significantly and bone turn-over was normal in children with noncomplicated type 1 diabetes mellitus, and BMD was not influenced by the duration or degree of metabolic control of diabetes. But, we need further study including other risk factors that have influences on BMD and bone metabolism in type 1 diabetes mellitu.
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