Double diabetes: type 2 diabetes mellitus combined with fulminant type 1 diabetes mellitus: a case report and literature review

Abstract

Objective To investigate and compare clinical features between type 2 diabetes mellitus (T2DM) combined with fulminant type 1 diabetes mellitus (FT1DM) and simple FT1DM. Methods A case of T2DM combined with FT1DM was reported, and the clinical features of T2DM combined with FT1DM were summarized and analyzed. The clinical characteristics between 21 T2DM combined with FT1DM patients and 161 simple FT1DM patients from Japan and 70 simple FT1DM patients from China were compared, and a t test was used for the comparisons. Results (1) Most patients with T2DM combined with FT1DM were male (male∶female was 14∶7) and old. The course of FT1DM was (4.4±1.7) days. All patients had negative islet autoantibodies. (2) Compared with simple FT1DM from Japan, patients with T2DM combined with FT1DM were older [(60.1±11.8) vs (39.1±15.7) years, P<0.001], had higher glycated hemoglobin A1c (HbA1c) levels (8.2%±1.6% vs 6.4%±0.9%, P<0.001), and were more obese [body mass index (BMI) was (23.7±5.7) vs (20.7±3.9) kg/m2, P=0.032]. (3) Compared with domestic FT1DM, the difference was similar, patients with T2DM combined with FT1DM were older [(60.1±11.8) vs (31.7±11.4) years, P<0.001], had higher HbA1c levels (8.2%±1.6% vs 6.8%±1.1%, P<0.001), and had longer course of disease [(4.4±1.7) vs (3.1±2.4) d, P=0.032], but there was no statistically significant difference in BMI [(23.7±5.7) vs (21.1±3.7) kg/m2, P=0.068]. Conclusion Double diabetes can be manifested as T2DM combined with FT1DM, which is characterized by a longer course of disease, older age, higher BMI and HbA1c level compared with simple FT1DM. Key words: Diabetes mellitus, type 2; Diabetes mellitus, type 1; Fulminant type 1 diabetes mellitus; Double diabetes