Abstract
Type 1 diabetes mellitus is classified as autoimmune or idiopathic. Rapid-onset type 1 diabetes with pancreatic exocrine dysfunction was defined as fulminant type 1 diabetes mellitus in Japan. We studied the clinical characteristics of 108 patients diagnosed with type 1 diabetes during 13 years and found fulminant type 1diabetes. When onset HbA1c was lower, patients tended to have higher blood glucose (p<0.001), higher age (p<0.05), and lower logarithmic urinary C-peptide (p<0.0001). We studied the GAD antibody in 98 patients.Of these, 13 had negative GAD antibodyand HbA1c of less than 8.5%, suspected to be f-ulminant type 1 diabetes. One patient had diabetic ketoacidosis 6 days after acute pancreatitis onset, 5 did not show increased serum pancreatic amylase, and 1 showed a slight IA-2 antibody increase.Of the 11 with fulminant type 1 diabetes, 9 had HLA DRB 1*0405-DQB 1*0401, as a haplotype susceptible to Japanese type 1 diabetes, and this haplotype may be related to this subtype. More cases should thus be studied to clarify the mechanism behind fulminant type 1 diabetes.
