title: A case of type 2 diabetes mellitus in an elderly patient with rapid attenuation of insulin secretion that resembled fulminant type 1 DM but with incomplete beta cell damage.
abstract: We recently encountered a 66-year-old Japanese man who had suffered from acute hyperglycemia following flu-like symptoms during treatment of type 2 diabetes. Despite significantly increased plasma glucose levels, HbA1c was only slightly elevated. The possibility of autoimmune type 1 diabetes was excluded because of negative islet-related autoantibodies. Serum levels of pancreatic exocrine enzymes, amylase, lipase, and elastase-l were elevated. However, the insulin-secreting function of his islets was not severely damaged. This case is particularly notable for two reasons. First, it showed a fulminant type 1 diabetes-like clinical onset, but his beta cell function was fairly preserved. Second, it developed during the treatment of type 2 diabetes in an elderly patient.
authors.affiliation: Department of Endocrinology, Tokyo Metropolitan Geriatric Hospital, Sakaecho, Tokyo, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tamura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Araki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Chiba
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Ishimaru
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Ishimaru
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Seijiro
authors.initials: S
authors.lastname: Mori
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hosoi
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000378:metabolism / Q000473:pathology*; D008297:Male
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin