Low hemoglobin A1c levels in a patient with diabetic ketoacidosis: Fulminant type 1 diabetes mellitus

Fulminant type 1 diabetes mellitus (FT1DM) is a clinical condition that is characterized by remarkably rapid and complete pancreatic β-cell destruction, rapid onset of hyperglycemic symptoms followed by ketoacidosis. In most cases this process takes a few days. Although rare, there have been clinic...

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Main Authors: Melikşah Keskin, Şenay Savaş-Erdeve, Semra Çetinkaya, Zehra Aycan
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2018-04-01
Series:The Turkish Journal of Pediatrics
Subjects:
Online Access:https://turkjpediatr.org/article/view/841
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author Melikşah Keskin
Şenay Savaş-Erdeve
Semra Çetinkaya
Zehra Aycan
author_facet Melikşah Keskin
Şenay Savaş-Erdeve
Semra Çetinkaya
Zehra Aycan
author_sort Melikşah Keskin
collection DOAJ
description Fulminant type 1 diabetes mellitus (FT1DM) is a clinical condition that is characterized by remarkably rapid and complete pancreatic β-cell destruction, rapid onset of hyperglycemic symptoms followed by ketoacidosis. In most cases this process takes a few days. Although rare, there have been clinical manifestations with a prolonged progress that lasts longer than one week. This study focused on the case of a 35-monthold boy who was referred to our clinic with the diagnosis of diabetic ketoacidosis, and later had a modest elevation in hemoglobin A1c (HbA1c) levels (6.7 %) incompatible with his significantly elevated blood glucose levels. The autoantibodies against pancreatic β-cells were negative. On the basis of these above mentioned findings, our patient was then diagnosed with fulminant type 1 diabetes mellitus. If patients with diabetic ketoacidosis have no elevation in HbA1c levels, they should be assessed for possible clinical factors that can lead to lower detectable levels of HbA1c. Furthermore, FT1DM which is characterized by very rapid and potentially fatal progression should be considered as a differential diagnosis in these patients.
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issn 0041-4301
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language English
publishDate 2018-04-01
publisher Hacettepe University Institute of Child Health
record_format Article
series The Turkish Journal of Pediatrics
spelling doaj-art-b5482ee98c8d47748e7be228c7139a3d2025-08-20T02:55:38ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212018-04-0160210.24953/turkjped.2018.02.015Low hemoglobin A1c levels in a patient with diabetic ketoacidosis: Fulminant type 1 diabetes mellitusMelikşah Keskin0Şenay Savaş-Erdeve1Semra Çetinkaya2Zehra Aycan3Pediatric Endocrinology Clinic, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey.Pediatric Endocrinology Clinic, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey.Pediatric Endocrinology Clinic, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey.Pediatric Endocrinology Clinic, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey. Fulminant type 1 diabetes mellitus (FT1DM) is a clinical condition that is characterized by remarkably rapid and complete pancreatic β-cell destruction, rapid onset of hyperglycemic symptoms followed by ketoacidosis. In most cases this process takes a few days. Although rare, there have been clinical manifestations with a prolonged progress that lasts longer than one week. This study focused on the case of a 35-monthold boy who was referred to our clinic with the diagnosis of diabetic ketoacidosis, and later had a modest elevation in hemoglobin A1c (HbA1c) levels (6.7 %) incompatible with his significantly elevated blood glucose levels. The autoantibodies against pancreatic β-cells were negative. On the basis of these above mentioned findings, our patient was then diagnosed with fulminant type 1 diabetes mellitus. If patients with diabetic ketoacidosis have no elevation in HbA1c levels, they should be assessed for possible clinical factors that can lead to lower detectable levels of HbA1c. Furthermore, FT1DM which is characterized by very rapid and potentially fatal progression should be considered as a differential diagnosis in these patients. https://turkjpediatr.org/article/view/841childhooddiabetic ketoacidosisinsulin dependent diabetes mellitus
spellingShingle Melikşah Keskin
Şenay Savaş-Erdeve
Semra Çetinkaya
Zehra Aycan
Low hemoglobin A1c levels in a patient with diabetic ketoacidosis: Fulminant type 1 diabetes mellitus
The Turkish Journal of Pediatrics
childhood
diabetic ketoacidosis
insulin dependent diabetes mellitus
title Low hemoglobin A1c levels in a patient with diabetic ketoacidosis: Fulminant type 1 diabetes mellitus
title_full Low hemoglobin A1c levels in a patient with diabetic ketoacidosis: Fulminant type 1 diabetes mellitus
title_fullStr Low hemoglobin A1c levels in a patient with diabetic ketoacidosis: Fulminant type 1 diabetes mellitus
title_full_unstemmed Low hemoglobin A1c levels in a patient with diabetic ketoacidosis: Fulminant type 1 diabetes mellitus
title_short Low hemoglobin A1c levels in a patient with diabetic ketoacidosis: Fulminant type 1 diabetes mellitus
title_sort low hemoglobin a1c levels in a patient with diabetic ketoacidosis fulminant type 1 diabetes mellitus
topic childhood
diabetic ketoacidosis
insulin dependent diabetes mellitus
url https://turkjpediatr.org/article/view/841
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AT senaysavaserdeve lowhemoglobina1clevelsinapatientwithdiabeticketoacidosisfulminanttype1diabetesmellitus
AT semracetinkaya lowhemoglobina1clevelsinapatientwithdiabeticketoacidosisfulminanttype1diabetesmellitus
AT zehraaycan lowhemoglobina1clevelsinapatientwithdiabeticketoacidosisfulminanttype1diabetesmellitus