Comparison of clinical features between fulminant type 1 diabetes and classical autoimmune type 1 diabetes / 生物医学工程学杂志

ABSTRACT

The data of 1,265 in-patients with diabetic ketosis or ketoacidosis treated in West China Hospital from October 2005 to October 2011 were analyzed retrospectively, and 8 of whom met fulminant type 1 diabetes (F1D) diagnostic criteria. The clinical features of the 8 F1D patients were investigated and compared with other 16 newly diagnosed autoimmune type 1 diabetes (T1D) patients, gender- and age-matched and with acute onset of ketoacidosis. During the six years between 2005 and 2011, the incidence of FID was 6.3 per thousand (8/T265) among all patients with diabetic ketosis or ketoacidosis admitted to the West China Hospital. The averaged age of the patients at onset of F1D was (30. 1 +/- 9. 7) years old, and the duration of diabetes was (4. 0 +/- 2. 4) days. Five of the 8 F1D patients had flu-like symptoms, and 7 had gastrointestinal symptoms. Blood glucose of F1D patients on admission was significantly higher than that of autoimmune T1D patients (P<0. 01), while the glycated hemoglobin (HbAlc) was lower than that of autoimmune T1D patients (P<0. 01). Additionally, fasting and postprandial C-peptide was significantly lower in F1D patients, with more severe acidosis, electrolytes and acid-base disturbances. The data suggest, that, compared with the autoimmune T1D patients, F1D patients have more complicated and more severe clinical manifestation with more severe hyperglycemia, more significant insulin deficiency and more obvious fluid electrolytes and acid-base disturbances. However, the sensitivity and the specificity of the diagnostic criteria of F1D are still needed to be improved for the Chinese people, so more multi-center and large-scale clinical trials should be conducted in the future.