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KMID : 1030220220230040278
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Journal of Korean Diabetes
2022 Volume.23 No. 4 p.278 ~ p.281
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A Case of Fulminant Type 1 Diabetes Mellitus after Recovery from COVID-19 Infection
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Suh Dong-Woo
Lee Cha-Gon
Lee Hong-Kyu
Kim Jin-Taek
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Abstract
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With the ongoing spread of coronavirus disease 2019 (COVID-19) infection, various complications have been reported. Here, we report a case of fulminant type 1 diabetes mellitus (T1DM) that developed abruptly after recovery from COVID-19 infection. A 41-year-old man with no relevant medical history visited the emergency room for polydipsia and polyuria 1 week in duration. The patient had just completed self-isolation at home after he tested positive for COVID-19 two weeks prior. Blood tests showed severe hyperglycemia of 721 mg/dL of glucose, elevated lipase (409 IU/L; normal range, 12~53 IU/L), elevated ketone bodies and metabolic acidosis (pH 7.18, bicarbonate 9.3 mEq/L). Glycated hemoglobin (HbA1C) was 6.0% and C-peptide 0.0 ng/mL. Meal-stimulated C-peptide level during hospitalization was also 0.0 ng/mL. GAD (glutamic acid decarboxylase) antibody was elevated (3.3 U/mL; normal, 0.0~0.9 U/mL) and insulin autoantibody was negative. Computed tomography showed no evidence of pancreatitis. Those findings fulfilled the diagnostic criteria of fulminant T1DM. Genetic testing revealed that the patient was positive for HLA-DRB1*04, HLA-DRB1*12, HLA-DQB1*03, and HLA-DQB1*04. To the best of our knowledge, this is the first case of fulminant T1DM reported to occur immediately after COVID-19 infection.
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KEYWORD
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Type 1 diabetes, COVID-19
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