Abstract
A 28-year-old woman delivered an infant in another hospital. Her previous health had been excellent. There was no history of obesity nor family history of diabetes mellitus.
The patient was well until the 36th week of gestation, when anorexia, thirstiness, polyuria and body weight loss occurred and further developed. She did not take any medication for diabetes mellitus, and was able to deliver a 2, 310 g premature infant in the 38th week of gestation.
The infant had no complication or malformation. At four days after delivery, the mother lost consciousness and was transferred to our hospital. Her general condition improved with insulin therapy, however, low C-peptide levels in both plasma and urine did not recover, and she was diagnosed as having insulin-dependent diabetes mellitus (IDDM). Laboratory determination of HLA type revealed DR4.
Tests for islet-cell antibodies (ICA), anti-insulin antibodies, and various anti-virus antibodies were negative. Although the incidence of IDDM during pregnancy is rare in Japan, increased incidence of IDDM in the third trimester of gestation has been reported in Scandinavian subjects. The case is noteworthy in view of study of pathogenetic mechanisms underlying IDDM.
