A Case of Recovery from a Fulminant Type 1 Diabetes Mellitus-like Episode During Pregnancy
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- Shibata Saori
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
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- Iwase Masanori
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
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- Fujii Hiroki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
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- Nakamura Udai
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
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- Sasaki Nobuhiro
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
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- Imoto Hirofumi
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
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- Nakanami Naoyuki
- Maternity and Perinatal Care Unit, Kyushu University Hospital
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- Iida Mitsuo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Bibliographic Information
- Other Title
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- 妊娠初期に膵外分泌酵素上昇を伴う糖尿病ケトアシドーシスを発症したが,短期間で耐糖能が正常化し正常分娩に至った1例
- 症例報告 妊娠初期に膵外分泌酵素上昇を伴う糖尿病ケトアシドーシスを発症したが、短期間で耐糖能が正常化し正常分娩に至った1例
- ショウレイ ホウコク ニンシン ショキ ニ スイガイブンピツ コウソ ジョウショウ オ トモナウ トウニョウビョウ ケトアシドーシス オ ハッショウ シタ ガ タンキカン デ タイトウノウ ガ セイジョウカ シ セイジョウ ブンベン ニ イタッタ 1レイ
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Abstract
A 26-year-old primipara with a positive family history of type 2 diabetes mellitus presented with abrupt onset of thirst, generalized malaise and slight disturbance of consciousness at 11 weeks of gestation. Her BMI was 15.7 kg/m2. Blood chemistry tests revealed a plasma glucose level 1,049 mg/dl, HbA1c of 5.5%, serum total ketone body level of 13,260 μmol/l; arterial blood gas analysis revealed a pH of 7.282 and BE of -17.9 mmol/l. The patient was diagnosed as having diabetic ketoacidosis and started on an intravenous infusion of insulin and saline. The patient tested negative for both anti-GAD antibody and the HLA haplotype associated with type 1 diabetes mellitus. However, the serum levels of exocrine pancreatic enzymes were elevated despite the absense of clinical findings of pancreatitis. After insulin therapy for 3 weeks, the blood glucose levels decreased, and the insulin therapy was discontinued. A 75-g OGTT revealed normal glucose tolerance. Glycemic control was well maintained by diet therapy alone until 39 weeks of gestation, when she delivered a healthy girl vaginally. While the clinical features in our patient resembled those of fulminant type 1 diabetes mellitus at the onset. Endogenous insulin secretion was preserved, and the glucose tolerance became entirely normal following short-term insulin therapy. Recovery from diabetic ketoacidosis during pregnancy is extremely rare.
Journal
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- Journal of the Japan Diabetes Society
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Journal of the Japan Diabetes Society 50 (1), 31-36, 2007
THE JAPAN DIABETES SOCIETY
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Keywords
Details 詳細情報について
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- CRID
- 1390282679882917504
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- NII Article ID
- 10018570382
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- NII Book ID
- AN00166576
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- ISSN
- 1881588X
- 0021437X
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- NDL BIB ID
- 8687131
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- CiNii Articles
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- Abstract License Flag
- Disallowed