A Case of Myotonic Dystrophy with Diabetic Ketoacidotic Coma

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  • Ogawa Yutaka
    Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine
  • Ota Akio
    Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine
  • Katabami Takuyuki
    Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine
  • Iwane Chizuko
    Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine
  • Saito Nobuhiko
    Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine
  • Shiraishi Makoto
    Department of Internal Medicine, Division of Neurology, St. Marianna University School of Medicine
  • Horiuchi Masahiro
    Department of Internal Medicine, Division of Neurology, St. Marianna University School of Medicine

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Other Title
  • 糖尿病性ケトアシドーシス性昏睡を合併した筋強直性ジストロフィーの１例
  • ショウレイ ホウコク(カントウ コウシンエツチホウカイ スイセン ロンブン) トウニョウビョウセイ ケトアシドーシスセイ コンスイ オ ガッペイ シタ キン ゴウチョクセイ ジストロフィー ノ 1レイ

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Abstract

A 54-year-old woman who saw an ophthalmologist for cataracts in 1988 and was diagnosed as diabetic continued insulin therapy from 1996 to March 2000, when she discontinued insulin injections because of anorexia. She came to our hospital reporting disturbed consciousness and was admitted based on a diagnosis of diabetic ketoacidotic coma. The recovery of motor functions was delayed and her muscle strength decreased despite improved biochemical laboratory data. Myotonic dystrophy (MD) was diagnosed based on DNA analysis. Although diabetes accompanied by MD is often followed by hyperinsulinemia, excessive insulin secretion was not found. No previous have, to our knowledge, described ketoacidotic coma developing in a patient with diabetes and MD.

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