BACKGROUND: Fulminant type 1 diabetes mellitus (FT1DM), a subtype of type 1 diabetes mellitus, was first reported as a disease entity in 2000. Ketoacidosis at initial onset due to acute pancreatic cell destruction makes early diagnosis and treatment for FT1DM mandatory. In the early period of FT1DM, haemoglobin (Hb)A(1C) levels are not markedly elevated. This study investigated serum glycated albumin (GA), which reflects acute short-term changes in plasma glucose, as a new clinical index for FT1DM at disease onset. METHODS: Subjects comprised 35 patients with FT1DM who had undergone measurement of HbA(1C) and serum GA at initial visit and 42 patients with type 2 diabetes mellitus (T2DM) with HbA(1C) <8.5% and no history of diabetes treatment as controls. RESULTS: HbA(1C) was significantly lower in FT1DM than in T2DM, whereas serum GA was significantly higher. GA/HbA(1C) ratio was thus significantly higher in FT1DM than in T2DM (3.9 +/- 0.5 versus 2.8 +/- 0.3; P < 0.0001). GA/HbA(1C) ratio was >3.2 in 41 of 42 FT1DM patients (98%), compared with only one of 32 T2DM patients (3%). CONCLUSIONS: Serum GA is significantly higher in FT1DM than in T2DM, whereas HbA(1C) is significantly lower. FT1DM can thus be distinguished from untreated T2DM by GA/HbA(1C) ratio at initial visit before treatment for diabetes.
BACKGROUND:Fulminant type 1 diabetes mellitus (FT1DM), a subtype of type 1 diabetes mellitus, was first reported as a disease entity in 2000. Ketoacidosis at initial onset due to acute pancreatic cell destruction makes early diagnosis and treatment for FT1DM mandatory. In the early period of FT1DM, haemoglobin (Hb)A(1C) levels are not markedly elevated. This study investigated serum glycated albumin (GA), which reflects acute short-term changes in plasma glucose, as a new clinical index for FT1DM at disease onset. METHODS: Subjects comprised 35 patients with FT1DM who had undergone measurement of HbA(1C) and serum GA at initial visit and 42 patients with type 2 diabetes mellitus (T2DM) with HbA(1C) <8.5% and no history of diabetes treatment as controls. RESULTS: HbA(1C) was significantly lower in FT1DM than in T2DM, whereas serum GA was significantly higher. GA/HbA(1C) ratio was thus significantly higher in FT1DM than in T2DM (3.9 +/- 0.5 versus 2.8 +/- 0.3; P < 0.0001). GA/HbA(1C) ratio was >3.2 in 41 of 42 FT1DM patients (98%), compared with only one of 32 T2DM patients (3%). CONCLUSIONS: Serum GA is significantly higher in FT1DM than in T2DM, whereas HbA(1C) is significantly lower. FT1DM can thus be distinguished from untreated T2DM by GA/HbA(1C) ratio at initial visit before treatment for diabetes.
Authors: S Suzuki; M Koga; S Amamiya; A Nakao; K Wada; K Okuhara; S Hayano; A R Sarhat; H Takahashi; K Matsuo; Y Tanahashi; K Fujieda Journal: Diabetologia Date: 2011-06-05 Impact factor: 10.122
Authors: Ji Woo Lee; Hyung Jin Kim; Young Se Kwon; Yong Hoon Jun; Soon Ki Kim; Jong Weon Choi; Ji Eun Lee Journal: Ann Pediatr Endocrinol Metab Date: 2013-12-31