Tamura Yoshiaki, Araki Atsushi, Chiba Yuko, Ishimaru Yasuaki, Ishimaru Yasuyo, Horiuchi Toshiyuki, Mori Seijiro, Hosoi Takayuki
Department of Endocrinology, Tokyo Metropolitan Geriatric Hospital, Sakaecho, Tokyo, Japan.
Endocr J. 2006 Oct;53(5):633-7. doi: 10.1507/endocrj.k06-008. Epub 2006 Aug 8.
We recently encountered a 66-year-old Japanese man who had suffered from acute hyperglycemia following flu-like symptoms during treatment of type 2 diabetes. Despite significantly increased plasma glucose levels, HbA1c was only slightly elevated. The possibility of autoimmune type 1 diabetes was excluded because of negative islet-related autoantibodies. Serum levels of pancreatic exocrine enzymes, amylase, lipase, and elastase-l were elevated. However, the insulin-secreting function of his islets was not severely damaged. This case is particularly notable for two reasons. First, it showed a fulminant type 1 diabetes-like clinical onset, but his beta cell function was fairly preserved. Second, it developed during the treatment of type 2 diabetes in an elderly patient.
我们最近遇到一名66岁的日本男性，他在2型糖尿病治疗期间出现类似流感症状后发生了急性高血糖。尽管血浆葡萄糖水平显著升高，但糖化血红蛋白（HbA1c）仅略有升高。由于胰岛相关自身抗体呈阴性，排除了自身免疫性1型糖尿病的可能性。血清中胰腺外分泌酶、淀粉酶、脂肪酶和弹性蛋白酶-1的水平升高。然而，他的胰岛胰岛素分泌功能并未受到严重损害。该病例有两个特别值得注意的原因。第一，它表现出暴发性1型糖尿病样的临床发病，但他的β细胞功能相当完好。第二，它发生在一名老年患者的2型糖尿病治疗期间。
