Fulminant type 1 diabetes: The clinical and continuous glucose monitoring characteristics in Chinese patients

摘要

Abstract The purpose of the current study was to investigate the clinical characteristics of fulminant type 1 diabetes mellitus ( FT 1 DM ) in Chinese patients and to further determine their glycaemic profiles through continuous glucose monitoring ( CGM ). Thirty subjects who were diagnosed with FT 1 DM according to the 2012 JDS criteria were enrolled. Clinical characteristics were compared to those reported in Japanese FT 1 DM . All subjects received retrospective CGM for 3?days after being converted to subcutaneous insulin injection therapy. Chinese FT 1 DM patients presented with a shorter duration of symptoms (2.84?±?2.42?days vs 4.4?±?3.1?days, P? ? 0.01), worse islet function (fasting C‐peptide, 0.09?±?0.11?ng/ mL vs 0.30?±?0.21?ng/ mL ; 2‐hour C‐peptide, 0.13?±?0.14?ng/ mL vs 0.30?±?0.30?ng/ mL , both P? ? 0.01), lower prevalence of flu‐like symptoms (46.7% vs 71.4%, P? ? 0.05), and a significantly higher GADA positive rate (23.3% vs 5.1%, P? ? 0.01) when compared with Japanese patients. The CGM results showed that the mean time in range ( TIR ) of FT 1 DM patients was 49.8?±?22.1%, while mean amplitude of glycaemic excursion ( MAGE ) and standard deviations of sensor glucose ( SDSG ) were 7.58?±?3.59?mmol/L and 3.19?±?1.22?mmol/L, respectively, with nearly 1/3 participants coefficient of variation ( CV )??36% (all are male), suggesting a large glucose fluctuation. The female patients were further divided into pregnancy‐related FT 1 DM ( PF ) and non‐ PF ( NPF ) subgroups (both n ? = ? 5), and we found that PF patients had a significantly higher TIR than NPF patients (77.0?±?16.1% vs 41.0?±?22.4%, P? ? 0.05). There were heterogeneities in the clinical characteristics of FT 1 DM patients, and the CGM results indicated a very low TIR and large glucose fluctuation which needs careful attention.