Arakawa Naoko, Aoyama Tomohisa, Suwanai Hirotsugu, Toda Gotaro, Takamoto Iseki, Okazaki Yukiko, Kadowaki Takashi, Yamauchi Toshimasa
Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Department of Endocrinology and Metabolism, Tokyo Metropolitan Health and Medical Treatment Corporation Tama-Hokubu Medical Center, Tokyo, Japan.
J Diabetes Investig. 2025 Apr;16(4):680-688. doi: 10.1111/jdi.14392. Epub 2024 Dec 23.
Diabetic chorea refers to sudden involuntary movements developing in people with diabetes mellitus and is known to occur mainly in those with severe hyperglycemia. We conducted a questionnaire survey of case-reporting facilities in Japan to elucidate their clinical characteristics.
We searched the PubMed and Ichushi databases for case reports published from January 1, 2012, to December 31, 2017, using "diabetes" and "chorea" as keywords, and sent a questionnaire to the reporting institutions.
Data from a total of 64 cases were included in this study. While most cases had severe hyperglycemia at the onset of diabetic chorea, hypoglycemia/improvement of the plasma glucose served as the trigger for the symptom in 14 cases (21.9%). The Early Remission Group (≤6 months) consisted of 39 cases (60.9%), while the Prolonged Partial Remission Group (>6 months) included 25 cases (39.1%). In the Prolonged Partial Remission Group (>6 months), there were more cases with widespread involuntary movement symptoms, a higher number of cases exhibiting typical imaging findings, and a greater incidence of chorea onset after the initiation of antidiabetic treatment, including hypoglycemia.
Most reported cases of diabetic chorea in Japan were elderly persons with type 2 diabetes mellitus and severe hyperglycemia, although there were also some cases in which the symptom developed in the setting of hypoglycemia. It has been suggested that rapid plasma glucose correction and hypoglycemia might be associated with the risk of development and prognosis of diabetic chorea.
糖尿病性舞蹈症是指糖尿病患者出现的突发不自主运动，已知主要发生在严重高血糖患者中。我们对日本的病例报告机构进行了问卷调查，以阐明其临床特征。
我们在PubMed和Ichushi数据库中检索了2012年1月1日至2017年12月31日发表的病例报告，使用“糖尿病”和“舞蹈症”作为关键词，并向报告机构发送了问卷。
本研究共纳入64例病例的数据。虽然大多数病例在糖尿病性舞蹈症发病时存在严重高血糖，但14例（21.9%）病例中低血糖/血糖水平改善是症状的触发因素。早期缓解组（≤6个月）包括39例（60.9%），而长期部分缓解组（>6个月）包括25例（39.1%）。在长期部分缓解组（>6个月）中，有更多病例出现广泛的不自主运动症状，更多病例表现出典型的影像学表现，并且在开始抗糖尿病治疗（包括低血糖）后舞蹈症发病的发生率更高。
在日本，大多数报告的糖尿病性舞蹈症病例是患有2型糖尿病和严重高血糖的老年人，尽管也有一些病例在低血糖情况下出现该症状。有人提出，血糖的快速纠正和低血糖可能与糖尿病性舞蹈症的发生风险和预后有关。
