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KMID : 0371619980140020347
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Journal of Wonkwang Medical Science
1998 Volume.14 No. 2 p.347 ~ p.355
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A case of 50 year-old woman with type 1 diabetes mellitus presented diabetic ketoacidosis as her diabetic symptoms
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Yoo Kyoung-Hoon
Baek Seung-Hoon
Lee Jae-Hong
Kim Kyeong-Nyeon
Cho Kyoo-Hye
Cho Chung-Gu
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Abstract
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Type 1 diabetes(Insulin-dependent) is caused by the selective destruction of the insulin secreting islet cells of the pancreas and is an autoimmune disease that occurs among genetically susceptible individuals most often develops in children and young adults, but sometimes in people over 40 years of age. These individuals may be characterized by autoantibodies to GAD and high-risk HLA DQ alleles, which are unlikely to be prevalent among patients with true type 2 diabetes. There are differences between type 1 patients of over 40 years at diagnosis and adult type 1 diabetic patients with onset at a younger age. There are strong evidence for humoral and cellular autoimmunity in adult type 1 diabetic patients with onset both before and after 40 years of age. The incidence of type 1 diabetes in the age group over 40 year at onset is variable to races and nations. The present study indicates that type 1 diabetes may develop at any age. Thus the life-time risk of developing type 1 is higher than hitherto expected. Adult-onset type 1 diabetes may represent a disease that is biologically distinct from youth-onset type 1, and it would be important to distinguish these two entities. A very large population base would be required to identify sufficent numbers of adult-onset type 1 cases for study of the etiology and pathogenesis of this disease. Diabetic ketoacidosis(DKA) is a common illness among individuals with insulin dependent diabetes mellitus considered largely preventable. The major metabolic derangements of type 1 diabetes are hyperglycemia, excessive ketonemia and ketonuria. Type 1 diabetes is usually believed to present acutely, and it is assumed that metabolic decompensation is sudden. DKA is an acute metabolic complication of diabetes mellitus that can be life threatening. Correct classification of diabetic patients in adulthood at the time of diagnosis is often difficult. The treatment of DKA should be started as soon as its diagnosed, and the goal of the therapy is to increase the rate of glucose utilization by insulin dependent-tissues. This case is type 1 diabetes of 50 year old woman who presented a diabetic ketoacidosis as her first symptom on a late-onset type 1 diabetes.
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KEYWORD
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Adult-onset type 1 diabetus, diabetic ketoacidosis
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