Fulminant Type 1 Diabetes Mellitus Complicated with a Life-threatening Electrolyte Abnormality and Abnormal Electrocardiogram Findings

• Published in: Internal Medicine Vol. 57; no. 18; pp. 2685 - 2688
• Main Authors: Kinoshita, Tomoe, Kaneto, Hideaki, Kawasaki, Fumiko, Anno, Takatoshi, Kurihara, Takeyuki, Yamada, Haruki, Oshiro, Yoshiyuki, Miyashita, Naoyuki, Okimoto, Niro, Kaku, Kohei
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.09.2018; Japan Science and Technology Agency
• Subjects: a life-threatening electrocardiographic abnormality; Arrhythmias, Cardiac - complications; Blood glucose; Case Report; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - physiopathology; diabetic ketoacidosis; Diabetic Ketoacidosis - complications; Diabetic Ketoacidosis - drug therapy; EKG; Electrocardiography; Electrolytes; Electrolytic cells; Fluid Therapy; fulminant type 1 diabetes mellitus; Glucose; Humans; Hyperkalemia; Hyperkalemia - complications; Hypoglycemic Agents - therapeutic use; Hyponatremia; Hyponatremia - complications; Hyponatremia - therapy; Insulin; Insulin - metabolism; Insulin - therapeutic use; Insulin Secretion; Insulin-Secreting Cells; Internal medicine; Ketoacidosis; Male; Middle Aged; Pancreas; Secretion; a life-threatening electrocardiographic abnormality; fulminant type 1 diabetes mellitus; diabetic ketoacidosis; hyperkalemia
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.0680-17

Fulminant type 1 diabetes mellitus (T1DM) is idiopathic T1DM with the rapid destruction of pancreatic β-cells. We herein report a 48-year-old man who developed fulminant T1DM complicated with a life-threatening electrolyte abnormality and abnormal electrocardiogram findings. He had no remarkable medical history, but one day, he developed general fatigue. His blood glucose level and HbA1c were 806 mg/dL and 6.3%, and his insulin secretion was markedly suppressed. He had ketoacidosis, hyponatremia and hyperkalemia. Furthermore, a life-threatening abnormality was noted on electrocardiogram. After fluid infusion and insulin therapy, the abnormality disappeared. In conclusion, we should bear in mind the possibility of fulminant T1DM in patients complaining of general malaise.