Two Cases of Type 1A Diabetes Associated with Diabetic Ketoacidosis and Thyrotoxicosis without Severe Hyperglycemia

Mitsui Eri, Yamamoto Tsunehiko, Yasuda Tetsuyuki, Miyashita Kazuyuki, Fujisawa Keiko, Fujiki Noritaka, Kuroda Akio, Kaneto Hideaki, Shimomura Iichiro

doi:10.11213/tonyobyo.54.916

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Other Title

著明な高血糖を呈さず甲状腺中毒症を契機に糖尿病ケトアシドーシスを発症した1A型糖尿病の2症例
チョメイナコウケットウオテイサズコウジョウセンチュウドクショウオケイキニトウニョウビョウケトアシドーシスオハッショウシタ 1Aガタトウニョウビョウノ 2 ショウレイ

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A 33-year-old woman who had suffered from thirst, polyposia, polyuria and body weight loss was admitted with diabetic ketoacidosis (DKA). Her plasma glucose level was mildly elevated (243 mg/dl), but the urinary ketone reaction was strongly positive. A 29-year-old woman who had suffered from slight fever, nausea and body weight loss was also admitted with DKA. Her plasma glucose level was moderately elevated (281 mg/dl), but the urinary ketone reaction was strongly positive. There seemed to be few symptoms, however thyrotoxicosis was suspected because of the low level of serum cholesterol and creatinine despite the dehydration. After the admission, painless thyroiditis and Basedow's disease were diagnosed based on the disease course, respectively. Thyrotoxicosis appeared to make a great contribution to ketone synthesis.<br> It is well known that autoimmune type 1 diabetes is closely associated with autoimmune thyroid disorder. In the case of DKA in type 1A diabetic patients with moderately elevated plasma glucose level and lower levels of serum cholesterol or creatinine as in these two cases, we should take concomitant thyrotoxicosis into consideration.<br>

Journal

Journal of the Japan Diabetes Society

Journal of the Japan Diabetes Society 54 (12), 916-921, 2011

THE JAPAN DIABETES SOCIETY

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