General Medicine  2009;10(1):23-27

Emaciated Patient with Slowly Progressed Type 1 Diabetes Mellitus who had hypoglycemia Despite Impaired Insulin Secretion

Takeshi Ito ; Nobuya Fujita ; Naoki Maeda ; Masayoshi Komura ; Hideto Tomioka ; Nobuki Ohnishi ; Kunihiko Arai ; Mizue Yokoyama ; Ryoji Yoshida

Keywords

slowly progressive type 1 diabetes mellitus; eating disorder; hypoglycemia; emaciation; insulin therapy

Country

Japan

Language

English

Abstract

We describe a 38-year-old, severely emaciated female with slowly progressive type 1 diabetes mellitus (SPIDDM), who had hypoglycemia due to fasting and an extremely low energy intake. After being diagnosed with diabetes mellitus (DM), she took in only 300-500 kcal per day and her weight had decreased to 30 kg, with a body mass index (BMI) of 11.4 kg/m2. She was admitted with hypoglycemia, and SPIDDM was confirmed by nearly-completely ceased insulin secretion and seropositivity towards anti-GAD antibody. After appropriate dietary therapy and insulin administration, she recovered from a state of emaciation and her glucose metabolism was restored. With this patient it proved very effective for the general physician to coordinate treatment for both diabetes and an eating disorder.