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一例伴有残余胰岛素分泌的暴发性1型糖尿病病例。

A Case of Fulminant Type 1 Diabetes With Residual Insulin Secretion.

作者信息

Kato Tomoko, Harada Norio, Nishikawa Yuki, Yamamoto Kana, Murakami Takaaki, Ueda Yohei, Okamoto Motozumi, Yabe Daisuke

机构信息

Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, JPN.

Endocrinology and Metabolism, University of Fukui School of Medical Sciences, Fukui, JPN.

出版信息

Cureus. 2025 Apr 21;17(4):e82751. doi: 10.7759/cureus.82751. eCollection 2025 Apr.

DOI:10.7759/cureus.82751
PMID:40406776
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12095886/
Abstract

A 67-year-old woman presented with fever and a cold a week later, with symptoms of hyperglycemia. After 10 days, her non-fasting blood glucose level was 586 mg/dL, and glycosylated hemoglobin (HbA1c) was 7.2%. She then developed diabetic ketosis and was treated with insulin. Her fasting C-peptide immunoreactivity (CPR) became 0.4 ng/mL. However, her insulin requirement was subsequently reduced. After two months, her CPR was 1.07 ng/mL at zero minutes and 2.04 ng/mL at six minutes in a glucagon stimulation test. Daily urinary CPR was 62 mg. Even though fulminant type 1 diabetes was indicated from the clinical course, insulin secretory ability improved.

摘要

一名67岁女性一周后出现发热和感冒,并伴有高血糖症状。10天后,她的非空腹血糖水平为586mg/dL,糖化血红蛋白(HbA1c)为7.2%。随后她发展为糖尿病酮症,并接受胰岛素治疗。她的空腹C肽免疫反应性(CPR)降至0.4ng/mL。然而,她随后的胰岛素需求量减少。两个月后,在胰高血糖素刺激试验中,她的CPR在零分钟时为1.07ng/mL,六分钟时为2.04ng/mL。每日尿CPR为62mg。尽管从临床病程来看提示为暴发性1型糖尿病,但胰岛素分泌能力有所改善。

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本文引用的文献

1
Anti-Islet Autoantibodies in Type 1 Diabetes.1 型糖尿病中的胰岛自身抗体。
Int J Mol Sci. 2023 Jun 11;24(12):10012. doi: 10.3390/ijms241210012.
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SYNDROMES OF KETOSIS-PRONE DIABETES.酮症倾向糖尿病综合征
Trans Am Clin Climatol Assoc. 2019;130:145-155.
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The remission phase in type 1 diabetes: Changing epidemiology, definitions, and emerging immuno-metabolic mechanisms.1 型糖尿病缓解期:不断变化的流行病学、定义和新出现的免疫代谢机制。
Diabetes Metab Res Rev. 2020 Feb;36(2):e3207. doi: 10.1002/dmrr.3207. Epub 2019 Aug 13.
4
A case of idiopathic type 1 diabetes with subsequent recovery of endogenous insulin secretion despite initial diagnosis of fulminant type 1 diabetes.一例特发性1型糖尿病患者,尽管最初诊断为暴发性1型糖尿病,但随后内源性胰岛素分泌恢复。
Endocr J. 2017 Mar 31;64(3):369-374. doi: 10.1507/endocrj.EJ16-0245. Epub 2017 Jan 6.
5
Report of the Committee of the Japan Diabetes Society on the Research of Fulminant and Acute-onset Type 1 Diabetes Mellitus: New diagnostic criteria of fulminant type 1 diabetes mellitus (2012).日本糖尿病学会关于暴发性和急性发作 1 型糖尿病研究的报告:暴发性 1 型糖尿病的新诊断标准(2012 年)。
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Class II HLA genotype in fulminant type 1 diabetes: A nationwide survey with reference to glutamic acid decarboxylase antibodies.Ⅱ类 HLA 基因型与暴发性 1 型糖尿病:一项全国性调查及谷氨酸脱羧酶抗体的参考
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Endogenous insulin secretion even at a very low level contributes to the stability of blood glucose control in fulminant type 1 diabetes.即使在非常低的水平下,内源性胰岛素分泌也有助于暴发性 1 型糖尿病患者血糖控制的稳定性。
J Diabetes Investig. 2010 Dec 3;1(6):283-5. doi: 10.1111/j.2040-1124.2010.00059.x.
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Fulminant type 1 diabetes with robust recovery of insulin secretion: a case report.暴发性 1 型糖尿病伴胰岛素分泌功能的快速恢复:病例报告。
Diabetes Res Clin Pract. 2013 May;100(2):e34-8. doi: 10.1016/j.diabres.2013.01.032. Epub 2013 Feb 19.
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Narrative review: ketosis-prone type 2 diabetes mellitus.叙述性综述:酮症倾向2型糖尿病
Ann Intern Med. 2006 Mar 7;144(5):350-7. doi: 10.7326/0003-4819-144-5-200603070-00011.
10
A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies. Osaka IDDM Study Group.一种以起病迅速且无糖尿病相关抗体为特征的1型糖尿病新亚型。大阪青少年糖尿病研究组。
N Engl J Med. 2000 Feb 3;342(5):301-7. doi: 10.1056/NEJM200002033420501.