Abstract
A 41-year-old woman with anorexia and stomachache on March 5, 2001, was diagnosed with acute gastritis with hyponatremia (Na: 125 mEq/l) 2 days later. Her consciousness rapidly worsened at night and she was brought to the emergency room. Laboratory data was as follows: plasma glucose: 1, 240 mg/dl, arterial blood pH: 6.9, HCO3: 2.3 mmol/l, Na: 116 mEq/l, K: 6.7 mEq/l, and urinary ketone bodies: positive. HbAic was 5.2%, but serum and urinary C-peptides were not detected. Serum concentrations of amylase, lipase, and elastase 1 were elevated, but returned to normal within 7 days. Diabetes-related autoantibodies including anti-GAD antibody and antiinsulin antibody were negative. These findings yielded a diagnosis of fulminant type 1 diabetes. Initial symptoms of fulminant type 1 diabetes may thus mimic those of gastritis or a common cold, without indicating hyperglycemia.
