国内299例暴发性1型糖尿病病例复习及其临床特点分析

目的:归纳总结国内暴发性1型糖尿病(FT1DM)的临床特征。方法:收集中文数据库中2005年1月至2018年12月公开发表的FT1DM相关文献，对其中符合纳入标准的279例病例及我院收治的20例患者资料进行汇总分析。结果:(1)自2005年起，国内对FT1DM的报道数逐年增加，南方地区报道病例数明显多于北方地区；(2)...

Analysis of clinical characteristics with literature review of 299 cases of fulminant type 1 diabetes in China

Objective To analyze the clinical characteristics of fulminant type 1 diabetes(FT1DM)in China.Methods Clinical data of 279 cases related to FT1DM in Chinese Database from January 2005 to December 2018 were collected,and other 20 patients from our hospital were included in the present study.Results(1)There has been a progressive increasing in the number of reported cases every year in China,and the number in the southern region were significantly more than that in the northern region.(2)The median age of the onset of FT1DM patients in China was 32.5 years old,without significant gender difference.Moreover,36.5%(54/148)of the female patients caught the disease during their prenatal period,most of them were onset in the second or third trimesters of pregnancy and 2 weeks after delivery(37/40),and the prognosis of the fetus was extremely poor.(3)Compared with new-onset type 1 diabetes,FT1DM patients were younger,and with higher blood glucose[(39.7±15.3)vs(21.2±9.9)mmol/L],higher serum creatinine[(188.4±115.9)vs(51.8±23.1)μmol/L],and higher amylase levels[245.5(26.0-5137.0)vs 54.7(14.0-404.9)U/L].FT1DM patients were with more severe acidosis,and lower HbA1C level[(6.6±0.8)%vs(12.9±2.5)%,P<0.01].(4)FT1DM patients may combine with multiple organ dysfunction or severe metabolic disorders,electrolyte disorders,as well as liver and kidney dysfunctions,and elevation of amylase and muscle enzymes.Conclusion FT1DM are with some clinical characteristics different from classic new-onset type 1 diabetes,including adult-onset,frequent in the southern China.Pregnancy may be a predisposing factor for female patients.Significant metabolic disorders and multiple organ involvements are common in the patients with FT1DM.