Obstetrics and gynaecology, Westmead Hospital, Westmead, New South Wales, Australia
Obstetrics and gynaecology, Westmead Hospital, Westmead, New South Wales, Australia.
BMJ Case Rep. 2023 Oct 31;16(10):e253585. doi: 10.1136/bcr-2022-253585.
Fulminant type 1 diabetes is a relatively new subtype of type 1 diabetes characterised by a sudden onset of severe diabetic ketoacidosis (DKA) in patients with no history of diabetes and can cause imminent death if untreated. We discuss a rare case of a Pacific Islander woman who was 36 weeks pregnant and presented to the emergency department with DKA and fetal death in utero having had a normal glucose tolerance test 4 weeks earlier. She was diagnosed with fulminant type 1 diabetes and was treated with an intravenous insulin-dextrose infusion. She delivered a stillborn female infant and was discharged on regular subcuticular insulin. This case is helpful in understanding a rare, lethal disease that is not well reported globally and especially in Australia, as it requires prompt recognition and treatment to prevent detrimental outcomes.
暴发性 1 型糖尿病是 1 型糖尿病的一种相对较新的亚型，其特征是无糖尿病病史的患者突然发生严重的糖尿病酮症酸中毒（DKA），如果不治疗可能会导致立即死亡。我们讨论了一个罕见的太平洋岛裔妇女的病例，她怀孕 36 周，因 DKA 并伴有宫内胎儿死亡而到急诊就诊，而在 4 周前她的葡萄糖耐量试验正常。她被诊断为暴发性 1 型糖尿病，并接受静脉胰岛素-葡萄糖输注治疗。她产下一名死胎女婴，随后出院并接受常规皮下胰岛素治疗。这个病例有助于了解一种罕见的致命疾病，这种疾病在全球，特别是在澳大利亚，报道得并不多，因为它需要及时识别和治疗，以防止不良后果。
