| Objective:By studying the treatment of fulminant type 1 diabetes (FT1DM) and follow-up results, discuss the treatment strategies and prognosis of the disease.Methods:The clinical data of 5 patients with FT1DM and 8 patients with T1DM were collected, admitted in endocrine metabolism department of Shangyu people’s hospital from January 2010 to January 2015, we analyzed the clinical characteristics, treatment and follow-up results of the 5 patients.Results:Compared to the autoimmune TID patients, the average age was older, the glycated hemoglobin (HbAlc) was lower (P<0.05), fasting and postprandial C-peptide was significantly lower in F1D patients, with more severe acidosis, electrolytes and acid-base disturbances. After 6-52 months, the islet function of these patients haven’t restored due to pancreas islet damage. All of them had poor blood glucose control, and didn’t appear obvious complications of both capillaries and large blood vessels. Compared to multiple dialy insulin injections, Patients who treated with continuous subcutaneous insulin infusion (CSII) had better blood glucose control, and lower ketoacidosis morbidity.Conclusion:FT1DM patients are in poor body condition at acute stage, with islet B cell function severely damaged, frequently followed multiple organ damages of liver, kidney, heart and so on. The prognosis is poor. As endocrinology emergency, it must attract clinical doctor’s attention. Patients with FT1DM had poor pancreas islet function, may require long-term CSII to control blood glucose and improve the prognosis. Measures such as the pancreas transplantation, pancreatic islets transplantation, pancreatic stem cells or therapeutic cloning can be taken to make type 1 diabetes non-insulin-dependent diabetes... |
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