Fulminant Type 1 Diabetes with Robust Recovery in Insulin Secretion in a Pregnant Woman as an Initial Manifestation of Third-Trimester Intrauterine Fetal Death.
- Author:
Mi Hae SEO
1
;
Hyosang HAN
;
Ji Yun JEONG
;
Jun Yong CHANG
;
Sun Young JUNG
Author Information
1. Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea. seomihye@schmc.ac.kr
- Publication Type:Case Report
- Keywords:
Fulminant type 1 diabetes mellitus;
Fetal death;
Insulin secretion
- MeSH:
Adult;
Autoantibodies;
Blood Glucose;
C-Peptide;
Diabetes Mellitus;
Diabetes Mellitus, Type 1;
Emergency Service, Hospital;
Female;
Fetal Death*;
Glucose Tolerance Test;
Humans;
Hyperglycemia;
Insulin*;
Ketone Bodies;
Ketosis;
Korea;
Pregnancy;
Pregnant Women*;
Reference Values;
Risk Factors;
Stillbirth
- From:Soonchunhyang Medical Science
2017;23(2):118-123
- CountryRepublic of Korea
- Language:English
-
Abstract:
Fulminant type 1 diabetes mellitus (FT1DM) is a clinical entity in which the process of beta-cell destruction and subsequent progression of hyperglycemia and ketoacidosis are extremely rapid. A 34-year-old woman without any known risk factor for diabetes mellitus experienced a sudden stillbirth at 30 weeks of gestation. She had normal oral glucose tolerance test during pregnancy. Her blood glucose level was 974 mg/dL. Her urine test for ketone bodies was positive. Her hemoglobin A1c level (6.8%) was near normal range at the first emergency room visit. These findings suggested a very recent onset of diabetes mellitus. Her serum C-peptide level was very low. Islet-related autoantibodies were undetectable. Her clinical course, biochemical, and immunological profiles were consistent with FT1DM. After fluid and insulin based management, beta-cell was rescued with insulin therapy during the evolution of FT1D. At 10 days after admission, maintenance dose of insulin was just 8 unit of insulin once daily. This is the first case of FT1DM with robust recovery in insulin secretion in a pregnant woman who had an initial manifestation of 3rd-trimester intrauterine fetal death in Korea.
