A Case of Fulminant Type 1 Diabetes Following Acute Pancreatitis during Early Pregnancy

Abstract

The patient was a 38-year old woman. She experienced epigastralgia on July 15, 2011. She was admitted to a hospital with a diagnosis of acute pancreatitis on July 20. Her plasma glucose level was 92 mg/dl at the time of admission. Although the acute pancreatitis was quickly resolved, nausea and general fatigue appeared on July 26. She was found to be in the fifth week of pregnancy, but she had a miscarriage the next day. She was discharged from the hospital on July 29, although the symptoms persisted. However, she was transported to this hospital on July 31, due to frequent vomiting that began the day after her discharge. Her plasma glucose level was 498 mg/dl at the time of admission and she had ketoacidosis. She was admitted with a diagnosis of diabetic ketoacidosis. She was diagnosed to have fulminant type 1 diabetes based on her HbA1c level (6.0 %) and low serum and urinary levels of CPR. Fulminant type 1 diabetes is associated with acute pancreatitis and pregnancy. This is an instructive case of fulminant type 1 diabetes that developed during early pregnancy (fifth week) along with the preexisitng acute pancreatitis more than 10 days before the onset of hyperglycemia.