ESPE Abstracts

Introduction: Fulminant type 1 diabetes (FT1D) occurs because of a sudden and almost total destruction of pancreatic β-cells, triggered by a viral infection. FT1DM may cause diabetic ketoacidosis (DKA) and even sudden death. Thus prompt diagnosis is vital.

Case Report: Antibiotic treatment was started for a 4-year-old female patient because of a fever and cough. On the second day of treatment, she was admitted with rapid breathing. Although she was given inhaler treatment, her clinical course worsened and admitted to the emergency. She was dehydrated and tachycardic and intercostal retractions were present, with hyperemic tonsils. She had a one-week history of polyuria and polydipsia. Laboratory test results are shown in Table 1. With the diagnosis of severe DKA, the patient was started on fluid and insulin therapy. After biochemical and clinical improvement was observed, subcutaneous insulin was started. FT1D was diagnosed, given the clinical course and laboratory results.

Conclusion: Early diagnosis of children with FT1D is vital to reduce the risk of sudden death and other complications. In children presenting to the hospital with flu-like symptoms, a detailed anamnesis should be taken and symptoms of hyperglycemia (polydipsia, polyuria) should be questioned. Detection of glucosuria and ketonuria on urinalysis will guide the diagnosis. Short-term symptoms, low c-peptide levels, and glycated hemoglobin below 8.7% should suggest the possibility of FT1D. Larger pediatric studies of FT1D are required to identify optimal diagnosis and management in the pediatric age group.