Department of Endocrinology and Metabolism, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Zhejiang Univ Sci B. 2010 Nov;11(11):848-50. doi: 10.1631/jzus.B1000080.
Fulminant type 1 diabetes is a recently discovered subtype of idiopathic type 1 diabetes, defined as diabetes with an extremely rapid process of β-cell destruction and progression to hyperglycemia and ketoacidosis. In this report, we present a case of fulminant type 1 diabetes in a 45-year-old Chinese woman, along with a review of the literature. The patient presented with sudden onset of polydipsia and polyuria after flu-like symptoms. Findings on admission included a high blood glucose level and ketoacidosis, but normal HbA1c level. The C-peptide stimulation test showed severe impairment of insulin secretion. Autoantibodies to glutamic acid decarboxylase (GAD) were negative. These results are compatible with the diagnosis of fulminant type 1 diabetes. Human leukocyte antigen-DR7 (HLA-DR7) was available in this case. It is concluded that this rapidly progressing type of diabetes exists, and we propose that HLA-DR7 might be predisposed to fulminant type 1 diabetes in Chinese patients.
暴发性 1 型糖尿病是一种新近发现的特发性 1 型糖尿病亚型，定义为β细胞破坏迅速进展至高血糖和酮症酸中毒的糖尿病。本报告介绍了一例 45 岁中国女性暴发性 1 型糖尿病病例，并对文献进行了回顾。该患者在流感样症状后突发多饮和多尿。入院时的检查结果包括高血糖和酮症酸中毒，但 HbA1c 水平正常。C 肽刺激试验显示胰岛素分泌严重受损。谷氨酸脱羧酶（GAD）抗体阴性。这些结果与暴发性 1 型糖尿病的诊断相符。该病例可检测到人类白细胞抗原-DR7（HLA-DR7）。因此，可以得出结论，确实存在这种快速进展的糖尿病类型，并且我们提出 HLA-DR7 可能使中国患者易患暴发性 1 型糖尿病。
