title: Fulminant type 1 diabetes mellitus: a study of nine cases.
abstract: OBJECTIVE
  The study aims to explore the prevalence and clinical features of fulminant type 1 diabetes mellitus (F1DM).
  
  
  METHODS
  We analyzed 11,202 patients who were diagnosed having diabetes and admitted to the Department of Endocrinology, Nanjin First Hospital, Nanjin, China, from September 2005 to April 2011. Among 198 patients classified having type 1 diabetes mellitus (T1DM), nine patients were diagnosed having F1DM. Clinical features of F1DM were analyzed and compared with typical T1DM.
  
  
  RESULTS
  The prevalence of F1DM was 4.5% (nine of 198 T1DM patients) in this study. F1DM patients had significantly high levels of random blood glucose (40±9 mmol/L). However, glycated hemoglobin (7.1±1.0%) and C-reactive peptide (0.21±0.15 μg/L) at 2 h postprandial were significantly lower in F1DM patients compared with typical T1DM patients. Six of them had flu-like symptoms. Five of them showed gastrointestinal symptoms. Three patients experienced disturbance of consciousness. However, none of these symptoms was found in patients with typical T1DM. A continuous intravenous insulin infusion therapy using a portable pump was given during the acute phase to control hyperglycemia and ketoacidosis. All F1DM patients survived after treatment.
  
  
  CONCLUSIONS
  In this single hospital-based study, nine Chinese patients met the criteria for diagnosis of F1DM. Although F1DM may be fatal, prompt treatment is required and useful to rescue these patients.
authors.affiliation: Department of Endocrinology, Nanjing First Hospital affiliated to Nanjing Medical University, Nanjing, China.
authors.forename: Xiao-Fei
authors.initials: XF
authors.lastname: Su
authors.forename: Li-Yuan
authors.initials: LY
authors.lastname: Fu
authors.forename: Jin-Dan
authors.initials: JD
authors.lastname: Wu
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Xu
authors.forename: Hui-Qin
authors.initials: HQ
authors.lastname: Li
authors.forename: Rui
authors.initials: R
authors.lastname: Sun
authors.forename: Lei
authors.initials: L
authors.lastname: Ye
authors.forename: Kok-Onn
authors.initials: KO
authors.lastname: Lee
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human