Fulminant type 1 diabetes linked with fetal death in utero

BMJ Case Rep. 2023 Oct 31;16(10):e253585. doi: 10.1136/bcr-2022-253585.

Abstract

Fulminant type 1 diabetes is a relatively new subtype of type 1 diabetes characterised by a sudden onset of severe diabetic ketoacidosis (DKA) in patients with no history of diabetes and can cause imminent death if untreated. We discuss a rare case of a Pacific Islander woman who was 36 weeks pregnant and presented to the emergency department with DKA and fetal death in utero having had a normal glucose tolerance test 4 weeks earlier. She was diagnosed with fulminant type 1 diabetes and was treated with an intravenous insulin-dextrose infusion. She delivered a stillborn female infant and was discharged on regular subcuticular insulin. This case is helpful in understanding a rare, lethal disease that is not well reported globally and especially in Australia, as it requires prompt recognition and treatment to prevent detrimental outcomes.

Keywords: Diabetes; Medical management; Pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / drug therapy
  • Diabetic Ketoacidosis* / diagnosis
  • Diabetic Ketoacidosis* / drug therapy
  • Diabetic Ketoacidosis* / etiology
  • Female
  • Fetal Death / etiology
  • Glucose Tolerance Test
  • Humans
  • Insulin / therapeutic use
  • Pregnancy

Substances

  • Insulin