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Changes in glucagon secretion induced by food intake in fulminant type 1 diabetes mellitus: a case report

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Abstract

Fulminant type 1 diabetes mellitus (FT1DM) is a subtype of type 1 diabetes mellitus and is characterized by a remarkably abrupt onset and almost complete destruction of β-cells within a few days. Here, we report a case of diabetic ketoacidosis in a 63-year-old man with no history of hyperglycemia. The patient was diagnosed with FT1DM and had almost no insulin secretion. We examined his insulin and glucagon secretions induced by a liquid meal test at the onset of FT1DM and 1 year later. The results suggested severely attenuated insulin secretion and an undetectable level of serum insulin 1 year after onset. In contrast, glucagon secretion, which was highly impaired at onset, increased in response to food intake. Although previous reports have suggested that both β- and α-cells of pancreatic islets are damaged in patients with FT1DM, the number of α-cells may increase over time after the onset of FT1DM.

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Acknowledgements

This work was carried out in cooperation with the Clinical Examination Unit, Hiroshima City Asa Citizens Hospital.

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Authors and Affiliations

  1. Department of Endocrinology and Diabetology, Hiroshima City Asa Citizens Hospital, 2-1-1, Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan

    Natsumi Himeno & Tsuguka Matsuda

  2. Department of Preventive Medicine for Diabetes and Lifestyle-related Disease, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan

    Masayasu Yoneda

Authors
  1. Natsumi Himeno
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  2. Tsuguka Matsuda
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  3. Masayasu Yoneda
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Contributions

NH and TM analyzed and interpreted patient data. NH performed data collection and wrote the manuscript with support from TM and MY. All authors have commented on previous versions of the manuscript. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Tsuguka Matsuda.

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Author Himeno, Matsuda, and Yoneda declare that they have no conflicts of interest.

Human rights statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later versions.

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Informed consent was obtained from the patient for this case report.

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Himeno, N., Matsuda, T. & Yoneda, M. Changes in glucagon secretion induced by food intake in fulminant type 1 diabetes mellitus: a case report. Diabetol Int 13, 304–308 (2022). https://doi.org/10.1007/s13340-021-00527-0

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  • DOI: https://doi.org/10.1007/s13340-021-00527-0

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