A Case of Juvenile Onset Non-Insulin-Dependent Diabetes Mellitus With Recurrent Ketoacidosis.
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概要
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A 19-year-old female was first admitted to our hospital with diabetic ketoacidosis at age 13. Her diabetes was well controlled with diet therapy alone during her initial hospital stay. After treatment was discontinued, however, diabetic ketoacidosis recurred, and a total of six admissions were required. Insulin therapy was started at the time of the second admission and continuously maintained thereafter. The insulin dose was increased during each of the subsequent admissions except the sixth, when it was decreased. At the time of each admission, urine c-peptide levels were very low, comparable to those of insulin-dependent diabetes mellitus (IDDM) patients. The cpeptide levels then increased, reaching the levels of non-insulin-dependent diabetes mellitus (NIDDM) patients by the time of discharge. A 75g oral glucose tolerance test revealed a delayed CPR response, but insulin secretory capacity was intact. Neither IDDM-associated HLA types nor islet-cell auto antibodies (ICA) were found. Consequently, a diagnosis of NIDDM was made. This atypical form of NIDDM is rare and may shed light on the pathogenesis of both IDDM and NIDDM.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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