2017 Volume 60 Issue 7 Pages 507-513
We herein report the case of an 81-year-old woman who developed type 1 diabetes after the administration of glucocorticoid. In September 2015, she was admitted to our hospital due to organizing pneumonia. The patient was treated with steroid pulse therapy followed by the oral administration of glucocorticoid. After the improvement of the patient's pneumonia, she was treated with oral glucocorticoid in an outpatient clinic. While her blood glucose level remained within the normal range in December, she suddenly complained of hyperglycemic symptoms in the middle of January 2016. Then, at the end of January, she was readmitted to the hospital due to diabetic ketosis. Her blood glucose and HbA1c levels were 432 mg/dL, and 8.9 %, respectively. Her serum pancreatic enzyme levels were slightly elevated, and she was negative for both GAD and IA-2 antibodies. The multiple daily injection of insulin (MDI) improved her hyperglycemia, but her serum C-peptide levels before and after meals were low at 0.25, and 0.56 ng/mL, respectively. She was found to have a high-risk HLA haplotype of type 1 diabetes, DRB1*04: 05-DQB1*04: 01. After discharge from our hospital, she was treated with MDI and glucocorticoid. Her serum C-peptide levels remained low during 2015 and 2016. The above findings suggest that the administration of glucocorticoid may have triggered type 1 diabetes in this patient.
