Six interesting case discussions of adult type 1 diabetes from Karnataka, South India
Keywords:
Adult Type 1 Diabetes, Autoimmune, C-Peptide Levels
Abstract
Type 1 diabetes can affect adults, although it is more common in children and young adults. We are presenting six cases of adult onset type 1diabetes. The etiology was autoimmune in five persons and idiopathic in one person. Two persons had diabetic ketoacidosis at presentation and four persons had symptoms of hyperglycemia. Fasting c-peptide was measured after blood glucose control and all six persons had very low c-peptide levels. Diabetes may present at any age so when there is strong clinical suspicion of type 1 diabetes in adults, physicians should do fasting C-peptide levels to diagnose type1 diabetes for management.
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References
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2. Verge CF, Gianani R, Kawasaki E, Yu L, Pietropaolo M, Chase HP, Eisenbarth GS, Jackson RA. Prediction of type I diabetes in first-degree relatives using a combination of insulin, GAD, and ICA512bdc/IA-2 autoantibodies. Diabetes. 1996 Jul 1;45(7):926-33.
3. Holmes GK. Coeliac disease and type 1 diabetes mellitus–the case for screening. Diabetic Medicine. 2001 Mar;18(3):169-77.
4. Perros P, McCrimmon RJ, Shaw G, Frier BM. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabetic medicine. 1995 Jul;12(7):622-7.
5. Winter WE, Harris N, Schatz D. Immunological markers in the diagnosis and prediction of autoimmune type 1a diabetes. Clinical diabetes. 2002 Oct 1;20(4):183-91.
6. Zimmet PZ, Tuomi T, Mackay IR, Rowley MJ, Knowles W, Cohen M, Lang DA. Latent autoimmune diabetes mellitus in adults (LADA): the role of antibodies to glutamic acid decarboxylase in diagnosis and prediction of insulin dependency. Diabetic medicine. 1994 Apr;11(3):299-303.
7. Klonoff DC. United Kingdom prospective diabetes study follow-up studies establish a legacy effect of therapy for hyperglycemia but not hypertension. Journal of Diabetes Science and Technology. 2008 Nov;2(6):922-4.
8. Liu E, Eisenbarth GS. Type 1A diabetes mellitus-associated autoimmunity. Endocrinology and metabolism clinics of North America. 2002 Jun 1;31(2):391-410.
9. Pihoker C, Gilliam LK, Hampe CS, Lernmark A. Autoantibodies in diabetes. Diabetes. 2005 Dec 1;54(suppl_2):S52-61.
10. Eisenbarth GS. Prevention of type 1A diabetes mellitus. Endocrine Practice. 2012 Sep 1;18(5):745-9.
11. Wenzlau JM, Liu Y, Yu L, Moua O, Fowler KT, Rangasamy S, Walters J, Eisenbarth GS, Davidson HW, Hutton JC. A common nonsynonymous single nucleotide polymorphism in the SLC30A8 gene determines ZnT8 autoantibody specificity in type 1 diabetes. Diabetes. 2008 Oct 1;57(10):2693-7.
12. Thunander M, Petersson C, Jonzon K, Fornander J, Ossiansson B, Torn C, Edvardsson S, Landin-Olsson M. Incidence of type 1 and type 2 diabetes in adults and children in Kronoberg, Sweden. Diabetes research and clinical practice. 2008 Nov 1;82(2):247-55.
13. Turner R, Stratton I, Horton V, Manley S, Zimmet P, Mackay IR, Shattock M, Bottazzo GF, Holman R. UKPDS 25: autoantibodies to islet-cell cytoplasm and glutamic acid decarboxylase for prediction of insulin requirement in type 2 diabetes. The Lancet. 1997 Nov 1;350(9087):1288-93.
14. Merger SR, Leslie RD, Boehm BO. The broad clinical phenotype of Type 1 diabetes at presentation. Diabetic Medicine. 2013 Feb;30(2):170-8.
15. Palmer JP, Fleming GA, Greenbaum CJ, Herold KC, Jansa LD, Kolb H, Lachin JM, Polonsky KS, Pozzilli P. Skyler JS, Steffes MW: C-peptide is the appropriate outcome measure for type 1 diabetes clinical trials to preserve ß-cell function: report of an ADA workshop, 21–22 October 2001. Diabetes 53: 250–264, 2004. Diabetes. 2004 Jul;53.
16. Diabetes Control and Complications Trial Research Group. Effect of intensive therapy on residual β-cell function in patients with type 1 diabetes in the Diabetes Control and Complications Trial. Ann Int Med. 1998;128:517-23.
17. Livingstone SJ, Looker HC, Hothersall EJ, Wild SH, Lindsay RS, Chalmers J, Cleland S, Leese GP, McKnight J, Morris AD, Pearson DW. Risk of cardiovascular disease and total mortality in adults with type 1 diabetes: Scottish registry linkage study.
18. Jacobson AM, Braffett BH, Cleary PA, Gubitosi-Klug RA, Larkin ME, DCCT/EDIC research group. The long-term effects of type 1 diabetes treatment and complications on health-related quality of life: a 23-year follow-up of the Diabetes Control and Complications/Epidemiology of Diabetes Interventions and Complications cohort. Diabetes care. 2013 Oct 1;36(10):3131-8.
19. Yamaguchi H, Kanadani T, Ohno M, Shirakami A. An ultra-elderly case of acute-onset autoimmune type 1 diabetes mellitus. Journal of Endocrinology and Metabolism. 2016 Apr 24;6(2):71-4.
20. Rogers MA, Kim C, Banerjee T, Lee JM. Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: a longitudinal study. BMC medicine. 2017 Dec;15:1-9.
21. Weng JianPing WJ, Zhou ZhiGuang ZZ, Guo LiXin GL, Zhu DaLong ZD, Ji LiNong JL, Luo XiaoPing LX, Mu YiMing MY, Jia WeiPing JW. Incidence of type 1 diabetes in China, 2010-13: population based study.
22. Thomas NJ, Jones SE, Weedon MN, Shields BM, Oram RA, Hattersley AT. Frequency and phenotype of type 1 diabetes in the first six decades of life: a cross-sectional, genetically stratified survival analysis from UK Biobank. The lancet Diabetes & endocrinology. 2018 Feb 1;6(2):122-9.
How to Cite
1.
R A kumar, Karthik M. Six interesting case discussions of adult type 1 diabetes from Karnataka, South India. Int J Med Res Rev [Internet]. 2025Mar.20 [cited 2025Apr.19];13(2):1-. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1539
Section
Case Series
Copyright (c) 2025 Author (s). Published by Siddharth Health Research and Social Welfare Society
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