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Fulminant type 1 diabetes as a high risk group for diabetic microangiopathy--a nationwide 5-year-study in Japan

Y Murase1, A Imagawa, T Hanafusa

  • 1First Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, and Department of Metabolism/Diabetes and Clinical Nutrition, Nagasaki University Hospital of Medicine and Dentistry, Japan.

Diabetologia
|January 20, 2007
PubMed

Insights

Fulminant type 1 diabetes patients show a significantly higher risk of developing microangiopathy compared to type 1A diabetes. This increased risk is linked to a lack of endogenous insulin secretion from diagnosis.

Area of Science:

  • Endocrinology
  • Diabetology
  • Nephrology

Background:

  • Fulminant type 1 diabetes is a novel subtype of type 1B diabetes.
  • Understanding its long-term complications is crucial.

Purpose of the Study:

  • To assess the development of microangiopathy in patients with fulminant type 1 diabetes.
  • To compare microangiopathy incidence with type 1A diabetes.

Main Methods:

  • Nationwide survey following 41 fulminant type 1 diabetes and 76 type 1A diabetes patients for 5 years.
  • Regular monitoring of glucose, HbA1c, albuminuria, C-peptide, blood pressure, insulin dosage, hypoglycemia, and clinical examinations.

Main Results:

  • 5-year microangiopathy incidence was 24.4% in fulminant type 1 diabetes vs. 2.6% in type 1A diabetes.
  • Higher rates of retinopathy, nephropathy, and neuropathy in fulminant type 1 diabetes.
  • Similar HbA1c but higher insulin needs and hypoglycemia, with lower C-peptide in fulminant type 1 diabetes.

Conclusions:

  • Fulminant type 1 diabetes patients are a high-risk subgroup for diabetic microangiopathy.
  • Lack of endogenous insulin secretion from onset contributes to microangiopathy risk.
Abstract

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