Fulminant type 1 diabetes with Shock rescue: a case report

The shock in diabetes often requires rapid and adequate fluid administration, however, we report an anomalous case of fulminant type 1 diabetes mellitus (FT1DM) in which the patient's condition worsened following fluid administration. In May 2020, a 29-year-old male presented with blood glucose of 89.8 mmol/L and diabetic ketoacidosis after a week of gastroenteritis. The diagnosis was finalized after C-peptide and Hemoglobin A1c (HbA1c) measurement. The patient was admitted with shock and received a positive fluid balance of 2800 ml in 5 h, but his condition deteriorated and progressed to multi-organ failure. This study attempts to explain the possible mechanisms and focuses on high-risk factors associated with FT1DM. Therefore, meticulous monitoring and individualized fluid administration strategies are crucial for the management of FT1DM. This case provides beneficial insights for clinical treatment of this condition.