2012 Volume 55 Issue 8 Pages 621-626
Laboratory data on a 41-year-old man hospitalized in January 2008 for "soft-drink" ketoacidosis showed that no glutamic acid decarboxylase (GAD) antibody had been detected and that urinary C-peptide (CPR) was within a normal 115.2 μg/day. These results yielded a diagnosis of type 2 diabetes. He was treated with biphasic insulin aspart 30 mix twice and metformin orally and discharged. His insulin requirement gradually decreased to a single oral hypoglycemic agent. Glycemic control remained good for the next 17 months. In June 2009, however, glycemic control worsened despite treatment, necessitating hospitalization. Laboratory data was positive for both GAD antibody and for other islet cell autoantibodies. Urinary CPR had also fallen to 33.1 μg/day. Human leukocyte antigen (HLA) typing detected A24 and DR9. These observations yielded a diagnosis of type 1 diabetes. This is an extremely rare case of type 1 diabetes diagnosed 17 months after "soft-drink" ketoacidosis onset.
