Sudden onset of immune-mediated type 1 diabetes mellitus in a 93-year-old woman: a case report
Type 1 diabetes mellitus (T1D) has long been considered a disorder of children and adolescents and to a lesser extent of adults . Over the past decades more insight was gained about the prevalence of T1D in older age groups although data remain scarce [1, 2, 3]. Diabetes is a heterogeneous disease and the clinical picture may be overlapping between type 1 and type 2 diabetes, especially in adults. Therefore, misclassification may be one of the most important issues in epidemiological studies on the prevalence of T1D in older age groups . A clinical picture with polydipsia, polyuria and ketoacidosis along with overt hyperglycemia are the diagnostic hallmarks of type 1 diabetes in children and young adults  but the clinical presentation is often less pronounced at advanced age. Worldwide, most studies have addressed T1D in children under age 15 years. Many countries have reported their incidence and trends in incidence of childhood-onset T1D. Few studies included...
KeywordsType 1 diabetes in elderly Sudden onset type 1 diabetes mellitus Diabetic ketoacidosis Anti GAD Anti IA2 HLA
The authors thank Bart Van der Auwera, Brussels Free University-VUB, Brussels, Belgium for his advice regarding the HLA-DQ genotype of the patient. IW is recipient of a senior clinical research fellowship from FWO–Vlaanderen. PO and IW. are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
PO is the treating diabetologist of the patient. PO and IW designed the study, wrote and revised the text, collected the data and performed the literature search. AL and GD provided assistance with the literature search and revised the paper.
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Conflict of interest
No potential conflicts of interest relevant to this article were reported.
Human and animal rights disclosure
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from the patient.