Skip to main content

Advertisement

Log in

Fulminant type 1 diabetes with Shock rescue: a case report

  • Brief report
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

The shock in diabetes often requires rapid and adequate fluid administration, however, we report an anomalous case of fulminant type 1 diabetes mellitus (FT1DM) in which the patient’s condition worsened following fluid administration. In May 2020, a 29-year-old male presented with blood glucose of 89.8 mmol/L and diabetic ketoacidosis after a week of gastroenteritis. The diagnosis was finalized after C-peptide and Hemoglobin A1c (HbA1c) measurement. The patient was admitted with shock and received a positive fluid balance of 2800 ml in 5 h, but his condition deteriorated and progressed to multi-organ failure. This study attempts to explain the possible mechanisms and focuses on high-risk factors associated with FT1DM. Therefore, meticulous monitoring and individualized fluid administration strategies are crucial for the management of FT1DM. This case provides beneficial insights for clinical treatment of this condition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

References

  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. Osaka IDDM Study Group. N. Engl. J. Med 342(5), 301–307 (2000)

    Article  CAS  PubMed  Google Scholar 

  2. L. Liu, L. Zeng, D. Sang, Z. Lu, J. Shen, Recent findings on fulminant type 1 diabetes. Diabetes Metab. Res. Rev. 34(1), e2928 (2018) https://onlinelibrary.wiley.com/doi/10.1002/dmrr.2928#

  3. Expert Committee on the D, Classification of Diabetes M, Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 26(Suppl 1), S5–S20 (2003)

    Article  Google Scholar 

  4. K.G. Alberti, P.Z. Zimmet, Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet. Med 15(7), 539–553 (1998)

    Article  CAS  PubMed  Google Scholar 

  5. 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(8), 2345–2352 (2003)

    Article  PubMed  Google Scholar 

  6. Y.M. Cho, J.T. Kim, K.S. Ko, B.K. Koo, S.W. Yang, M.H. Park et al. Fulminant type 1 diabetes in Korea: high prevalence among patients with adult-onset type 1 diabetes. Diabetologia 50(11), 2276–2279 (2007)

    Article  CAS  PubMed  Google Scholar 

  7. S. Liu, A. Xu, T. Liu, L. Tang, B. Huang, H. Shao, Clinical characteristics of fulminant Type 1 diabetes mellitus. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 45(12), 1437–1443 (2020)

    PubMed  Google Scholar 

  8. Y. Hosokawa, T. Hanafusa, A. Imagawa, Pathogenesis of fulminant type 1 diabetes: Genes, viruses and the immune mechanism, and usefulness of patient-derived induced pluripotent stem cells for future research. J. Diabetes Investig. 10(5), 1158–1164 (2019)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. A. Imagawa, T. Hanafusa, T. Awata, H. Ikegami, Y. Uchigata, H. Osawa et al. 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). J. Diabetes Investig. 3(6), 536–539 (2012)

    Article  PubMed  PubMed Central  Google Scholar 

  10. K.H.A. Choy, T. Wong, R.H.M. Cao, J.R. Flack. Fulminant type 1 diabetes mellitus in a GDM pregnancy: early recognition is vital for maternal and fetal outcomes. Endocrinol. Diabetes Metabol Case Rep. 2022(1), (2022) https://edm.bioscientifica.com/view/journals/edm/2022/1/EDM22-0262.xml

  11. W. You, J. Yang, Y. Liu, W. Wang, L. Zhu, W. Wang et al. Fulminant type 1 diabetes mellitus: Two case reports. Medicine 98(5), e14319 (2019)

    Article  PubMed  PubMed Central  Google Scholar 

  12. F. Egashira, M. Kawashima, A. Morikawa, M. Kosuda, H. Ishihara, K. Watanabe, A rare case of fulminant type 1 diabetes mellitus accompanied by both acute pancreatitis and myocarditis - case report. BMC Endocr. Disord. 20(1), 127 (2020)

    Article  PubMed  PubMed Central  Google Scholar 

  13. N. Ohara, M. Kaneko, H. Kuwano, K. Ebe, T. Fujita, T. Nagai et al. Erratum: fulminant type 1 diabetes mellitus and fulminant viral myocarditis. Int Heart J. 56(3), 363 (2015)

    Article  PubMed  Google Scholar 

  14. R. Sugawara, H. Sugiyama, K. Nakamura, K. Tohgi, T. Hongo, M. Tsuchiya et al. Electron microscopy revealed massive lipid droplets in cardiomyocytes in a patient with cardiogenic shock following a fulminant type 1 diabetes mellitus. Int. Heart J. 62(1), 197–200 (2021)

    Article  PubMed  Google Scholar 

  15. J. Bauersachs, S. Soltani, Guidelines of the ESC 2021 on heart failure. Herz 47(1), 12–18 (2022)

    Article  PubMed  Google Scholar 

  16. X.Y. Wang, F. Zhang, C. Zhang, L.R. Zheng, J. Yang, The biomarkers for acute myocardial infarction and heart failure. Biomed. Res. Int. 2020, 2018035 (2020)

    PubMed  PubMed Central  Google Scholar 

  17. M.Y. Baden, A. Imagawa, H. Iwahashi, I. Shimomura, T. Awata, H. Ikegami et al. Risk factors for sudden death and cardiac arrest at the onset of fulminant type 1 diabetes mellitus. Diabetol. Int. 7(3), 281–288 (2016)

    Article  PubMed  Google Scholar 

  18. Y.N. Chen, M.W. Zhao, J. Cui, H.B. Yao, Acute pancreatitis may be a pathogenic factor of fulminant type 1 diabetes mellitus. Chin. Med J. 134(9), 1127–1128 (2020)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. M. Takita, E. Jimbo, T. Fukui, K. Aida, A. Shimada, Y. Oikawa et al. Unique inflammatory changes in exocrine and endocrine pancreas in enterovirus-induced fulminant type 1 diabetes. J. Clin. Endocrinol. Metab. 104(10), 4282–4294 (2019)

    Article  PubMed  Google Scholar 

  20. S. Tanaka, M. Hishiki, J. Ogasawara, E. Sorimachi, M. Nakayama, The deterioration of the glycemic profile during hormone replacement therapy in a patient with fulminant type 1 diabetes. Intern. Med. 56(5), 531–534 (2017)

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yingying Ding.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Consent to publish/participate

This study has obtained patient consent and signed an informed consent form, which meets ethical requirements.

Informed consent

The patient provided written informed consent for the publication of this report.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dong, H., Ding, Y., Lai, J. et al. Fulminant type 1 diabetes with Shock rescue: a case report. Endocrine 84, 350–354 (2024). https://doi.org/10.1007/s12020-023-03646-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-023-03646-7

Keywords

Navigation