A Case of Fulminant Type 1 Diabetes Mellitus in an Elderly Patient

Abstract

Insulin deficiency due to destruction of pancreatic β-cells is a typical characteristic of type 1 diabetes mellitus (DM). In 2000 Imagawa proposed a novel diagnostic model defining “fulminant type 1 DM” as developing rapidly without any evidence of autoimmunity, and ever since there have been many reports regarding the matter in Japan. In 2004, the first fulminant type 1 diabetes case was reported in Korea; however, there have been few reports since then. We present a case of a 60-year-old man who suffered from excessive thirst and polyuria after myalgia. Laboratory findings revealed a high blood glucose level and evidence of diabetic ketoacidosis, but the HbA1c level was within the normal range. The serum C-peptide level was very low and antibodies to glutamic acid decarboxylase were negative. These findings suggested fulminant type 1 diabetes. This patient has shown improvement in symptoms and examination results without complications after being treated with insulin therapy with hydration, throughout 6-months follow-up period.