Journal
DIABETES-METABOLISM RESEARCH AND REVIEWS
Volume 27, Issue 1, Pages 70-78Publisher
WILEY
DOI: 10.1002/dmrr.1148
Keywords
fulminant type 1 diabetes; autoimmunity; pathogenesis; susceptibility
Categories
Funding
- China's State Education Commission [2002-48]
- Ministry of Education [200805330055]
- Hunan Province Department of Public Health [A2004-004]
- Changsha Scientific Bureau [K061025-32]
- National High Technology Research and Development Program [2006AA02A409]
- Science and Technology Bureau of Hunan Province China [2010SK2007]
- Ministry of Science and Technology [2009CB825605, 2006CB503901]
Ask authors/readers for more resources
Background Fulminant type 1 diabetes mellitus (T1DM) is characterized by abrupt onset of hyperglycemia and rapid progression to ketoacidosis. This study aimed at examining the clinical and autoimmunity features of fulminant T1DM in Chinese. Methods A total of 24 patients with fulminant T1DM and 48 classical autoimmune T1DM patients with acute onset of ketoacidosis were recruited. Anthropometric and biochemical parameters were tested. Serum antibodies against glutamic acid decarboxylase 65, tyrosine phosphatase-2 and zinc transporter 8 were measured, and human leukocyte antigen-DQ haplotypes were determined. Peripheral glutamic acid decarboxylase 65-specific T-cell responses in some subjects were determined. Results Compared with autoimmune T1DM patients, patients with fulminant T1DM displayed more flu-like and gastrointestinal symptoms, and had significantly higher concentrations of plasma glucose, more severe ketoacidosis, very low levels of pancreatic beta-cell reserve, but only slightly increased haemoglobin A(1c) levels. In some patients, the disease onset was associated with drug-related hypersensitivity, pregnancy, or positive serum IgM against viruses. Forty percent (8/20) had low titres of autoantibodies against at least one of the islet autoantigens tested. Three out of six patients had positive glutamic acid decarboxylase-reactive Th1 responses. The frequency of human leukocyte antigen -DQA1*0102-DQB1*0601 haplotype was significantly higher in patients with fulminant T1DM. Conclusions Fulminant T1DM is a distinct entity with unique clinical characteristics and may be mediated by multiple factors, including viral infection, pregnancy, and drug sensitivity syndrome, among others, in the presence of humoral and/or cellular autoimmunity and susceptible genetic background. Copyright (C) 2010 John Wiley & Sons, Ltd.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available