Endocrine

, Volume 40, Issue 3, pp 408–412 | Cite as

Clinical characteristics of fulminant type 1 diabetes associated with pregnancy in China

  • Lan Liu
  • Jiping Mao
  • Zeyuan Lu
  • Xiaojie Yan
  • Xiaosu Bai
  • Yiyi Ye
  • Gang Zou
Original Article

Abstract

To report 12 cases of pregnancy-associated fulminant type 1 diabetes mellitus (PF) found in China from 2003 to 2010. The clinical and biochemical characteristics of these cases with PF were compared with a group of cases of child-bearing age with fulminant type 1 diabetes that was not associated with pregnancy (NPF). The clinical and biochemical characteristics of 12 PF cases were analyzed retrospectively and then compared with those characteristics of 20 NPF cases in China. The difference between Chinese and Japanese PF cases was investigated. The mean values of the characteristics from PF and NPF cases in China, including postprandial serum C-peptide concentration, plasma glucose concentration, and serum chloride were different. Compared to the 22 PF cases in Japan, the mean age of these 12 PF cases was much younger. The mean fasting and postprandial serum C-peptide concentration level were lower, and the mean HbA1c levels was higher in 12 PF cases in China. Eight of 12 PF cases in China developed the disease during pregnancy. Other four PF case developed the disease within 2 weeks after delivery. 12 PF cases in China showed more severe beta-cell destruction, the prognosis of their fetuses was extremely poor.

Keywords

Fulminant Type 1 diabetes Pregnancy China 

Notes

Acknowledgments

We would like to thank the following hospitals: Hangzhou First People Hospital, Dalian Forth People Hospital, Chinese National Petroleum East Corporation Center Hospital, Nanjing Medical University First Hospital, Sun Yat-sen University Third Hospital, Kaohsiung Medical University Hospital, Zhejiang University School of Medicine Affiliated Sir Run Run Shaw Hospital, Hebei Xuanhua General Staff Communication Training Base Hospital, Zunyi Medical College Hospital, Shanghai Jiaotong University Affi1iated Sixth People Hospital, General Hospital of Tianjin Dagang Oilfield, Peking Union Medical College Hospital, Guangxi Medical University First Hospital, Sun Yat-sen University Bo Ji Hospital, Ningbo Beilun People Hospital, Fudan University Hua Shan Hospital, Xuzhou Medical College Hospital, Weifang Medical College Hospital, Inner Mongolia Medical College Hospital, Xi’an Jiaotong University First Hospital.

References

  1. 1.
    A. Imagawa, T. Hanafusa, J. Miyagawa, Y. Matsuzawa, A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies. N. Engl. J. Med. 342, 301–307 (2000)PubMedCrossRefGoogle Scholar
  2. 2.
    A. Imagawa, T. Hanafusa, Y. Uchigata, A. Kanatsuka, E. Kawasaki, T. Kobayashi et al., Fulminant type 1 diabetes- a nationwide survey in Japan. Diabetes Care 26, 2345–2352 (2003)PubMedCrossRefGoogle Scholar
  3. 3.
    I. Shimizu, H. Makino, H. Osawa, E. Kounoue, A. Imagawa, T. Hanafusa et al., Association of fulminant type 1 diabetes with pregnancy. Diabetes Res. Clin. Pract. 62, 33–38 (2003)PubMedCrossRefGoogle Scholar
  4. 4.
    I. Shimizu, H. Makino, A. Imagawa, H. Iwahashi, Y. Uchigata, A. Kanatsuka et al., Clinical and immunogenetic characteristics of fulminant type 1 diabetes associated with pregnancy. J. Clin. Endocrinol. Metab. 91, 471–476 (2006)PubMedCrossRefGoogle Scholar
  5. 5.
    L. Liu, Z.Y. Lu, Polydipsia, polyuria, deep breath and acanthosis nigricans-like changes in skin. New Med. 40, 424–426 (2009)Google Scholar
  6. 6.
    T. Wang, X.H. Xiao, W.H. Li, T. Yuan, X.F. Sun, H. Wang, Fulminant type 1 diabetes: report of two cases. Chin. Med. J. 121, 181–182 (2008)PubMedGoogle Scholar
  7. 7.
    F. Liu, J. Zhou, G.Q. Zang, W.X. Chen, Y.Q. Bao, N.S. Wang et al., Two cases of fulminant type 1 diabetes with extremely elevated muscle enzymes. Chin. J. Endocrinol. Metab. 25, 127–130 (2009)Google Scholar
  8. 8.
    Z.Y. Lu, L. Liu, H. Shao, L.P. Lai, G. Zou, X.J. Yan, Clinical analysis of five cases of fulminant type 1 diabetes mellitus. Chin. J. Endocrinol. Metab. 26, 192–194 (2010)Google Scholar
  9. 9.
    C. Zhen, Z. Wang, Y.Y. Zhang, Y.Y. Tan, C. Chen, H.F. Zhou, Epidemiological investigation of fulminant type 1 diabetes. Chin. J. Diabetes 17, 646–648 (2009)Google Scholar
  10. 10.
    C. Zheng, Z.G. Zhou, L. Yang, J. Lin, G. Huang, X. Li et al., Fulminant type 1 diabetes mellitus exhibits distinct clinical and autoimmunity features from classical type 1 diabetes mellitus in Chinese. Diabetes Metab. Res. Rev. 27, 70–78 (2011)PubMedCrossRefGoogle Scholar
  11. 11.
    A. Imagawa, T. Hanafusa, Fulminant type 1 diabetes mellitus. Endocr. J. 53, 577–584 (2006)PubMedCrossRefGoogle Scholar
  12. 12.
    Y.G. Zhao, L.Q. Zhuang, Metabolic changes in normal pregnancy and gestational diabetes. Chin. J. Obstet Gynecol. 32, 248–250 (1997)Google Scholar
  13. 13.
    L. Weiss, S. Bernstein, R. Jones, Preimplantation factor (PIF) analog prevents type I diabetes mellitus (TIDM) development by preserving pancreatic function in NOD mice. Endocrine. (2011). doi: 10.1007/s12020-011-9438-5. Online First, 22 March (2011)

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Lan Liu
    • 1
  • Jiping Mao
    • 2
  • Zeyuan Lu
    • 1
  • Xiaojie Yan
    • 1
  • Xiaosu Bai
    • 3
  • Yiyi Ye
    • 1
  • Gang Zou
    • 1
  1. 1.Department of EndocrinologyAffiliated Futian Hospital of Guangdong Medical CollegeShenzhenChina
  2. 2.Department of EndocrinologyCentral South University Second Xiangya HospitalChangshaChina
  3. 3.Department of GeriatricsAffiliated Futian Hospital of Guangdong Medical CollegeShenzhenChina

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