Recent findings on fulminant type 1 diabetes
- Resource Type
- Authors
- Zeyuan Lu; Ling Zeng; Jie Shen; Dan Sang; Lan Liu
- Source
- Diabetes/metabolism research and reviews. 34(1)
- Subject
- 0301 basic medicine
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Fulminant
030209 endocrinology & metabolism
Human leukocyte antigen
Type 2 diabetes
03 medical and health sciences
0302 clinical medicine
Endocrinology
Immune system
Internal medicine
Diabetes mellitus
Insulin-Secreting Cells
Internal Medicine
medicine
Animals
Humans
Type 1 diabetes
Innate immune system
business.industry
Insulin
medicine.disease
030104 developmental biology
Diabetes Mellitus, Type 1
Immunology
business
- Language
- ISSN
- 1520-7560
Fulminant type 1 diabetes (fT1D) is a new subtype of type 1 diabetes proposed by Imagawa in 2000. It is a clinical syndrome characterized by a markedly rapid and almost complete destruction of pancreatic β cells. Metabolic derangement is more severe in this subtype than in autoimmune type 1 diabetes. The incidence of fT1D is associated with HLA DRB1*04:05DQB1*04:01; both innate and acquired immune disorders might contribute to the development of fT1D. The presence of specific innate immune responses to enterovirus infection connected with enhanced adaptive immune pathways responsible for aggressive β cell toxicity in fT1D. The process of β cell destruction is extremely rapid in fT1D, and the insulin secretary capacity rarely recovers after the onset. The serum glycated albumin to glycated haemoglobin ratio is significantly higher in fT1D; a cut-off value of 3.2 for serum glycated albumin to glycated haemoglobin ratio yielded 97% sensitivity and 98% specificity for differentiating fT1D from type 2 diabetes. Fulminant type 1 diabetes is associated with pregnancy. This article also updates the diagnostic criteria for fT1D by the Japanese Diabetes Association in 2012.