A Case of Fulminant Type 1 Diabetes Mellitus Developed in Late Pregnancy and Achieved Successful Delivery

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  • Komiya Tomoko
    Department of Diabetes and Endocrinology, Japanese Red Cross Saitama Hospital
  • Yamaoka Kou
    Department of Diabetes and Endocrinology, Japanese Red Cross Saitama Hospital
  • Namai Kazuyuki
    Department of Diabetes and Endocrinology, Japanese Red Cross Saitama Hospital
  • Ban Masaaki
    Department of Obstetrics and Gynecology, Japanese Red Cross Saitama Hospital

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  • 妊娠後期に劇症1型糖尿病を発症したが正常分娩に至った1例

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<p>We herein report the case of a 33-year-old pregnant woman who developed fulminant type 1 diabetes mellitus. The results of a routine urine sugar test during gestation had been negative. She visited our hospital with complaints of abdominal pain and decreased fetal movement at 30 weeks and 4 days of gestation. She was admitted immediately because fetal heart rate monitoring showed severe late deceleration. On admission, her blood glucose level was 601 mg/dL, HbA1c level 5.5 %, urinary ketone bodies 4+, 24-h urine CPR (C-peptide immunoreactivity) concentration <1.1 μg/day, blood gas analysis pH 7.238, and BE−16.7 mmol/L. Flulike symptom occurred 5 days before visiting our hospital, and thirst, polydipsia, and polyuria occurred 2 days before visiting. She was diagnosed with fulminant type 1 diabetes and treated with continuous subcutaneous insulin infusion and a large amount of fluid replacement with normal saline. The treatment improved her diabetic ketoacidosis, and the fetal movements recovered. She delivered her infant naturally at 38 weeks and 2 days of gestation. Fulminant type 1 diabetes in pregnant women usually leads to a poor outcome. This case is noteworthy as a report of the successful treatment with insulin and natural delivery in a pregnant patient with fulminant type 1 diabetes.</p>

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