Prevalence and clinical characteristics of fulminant type 1 diabetes mellitus in Korean adults: A multi-institutional joint research

J Diabetes Investig. 2022 Jan;13(1):47-53. doi: 10.1111/jdi.13638. Epub 2021 Aug 31.

Abstract

Aims/introduction: We aimed to determine the hospital-based prevalence and clinical features of fulminant type 1 diabetes mellitus in Korea.

Materials and methods: We identified all patients with diabetes who regularly visited the Endocrinology outpatient clinics at eight centers for a period >1 year between January 2012 and June 2017. We investigated their medical records retrospectively.

Results: During this period, 76,309 patients with diabetes had been regularly followed up. Among them, 913 (1.2%) patients had type 1 diabetes mellitus . There were 462 patients with type 1 diabetes mellitus whose data at the time of the first diagnosis could be identified (359 and 103 with non-ketosis and ketosis onset, respectively). Of these, 15 (3.2% of type 1 diabetes mellitus, 14.6% of ketosis onset diabetes) patients had fulminant type 1 diabetes mellitus. The median ages at diagnosis were 40 and 27 years in the fulminant type 1 diabetes mellitus and non-fulminant type 1 diabetes mellitus groups, respectively. The patients with fulminant type 1 diabetes mellitus had higher body mass index, lower glycated hemoglobin and fasting/peak C-peptide, and lower frequent glutamic acid decarboxylase antibody-positive rate (P =0.0010) at diagnosis. Furthermore, they had lower glycated hemoglobin at the last follow-up examination than those with non-fulminant type 1 diabetes mellitus.

Conclusions: In this study, the prevalence of type 1 diabetes mellitus was 1.2% among all patients with diabetes, and that of fulminant type 1 diabetes mellitus was 3.2% among those newly diagnosed with type 1 diabetes mellitus. The glycated hemoglobin levels were lower in patients with fulminant type 1 diabetes mellitus than in those with non-fulminant type 1 diabetes mellitus at diagnosis and at the last follow-up examination.

Keywords: Fulminant type 1 diabetes mellitus; Korea; Prevalence.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Asian People / statistics & numerical data*
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Body Mass Index
  • C-Peptide / blood
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetic Ketoacidosis / complications
  • Diabetic Ketoacidosis / epidemiology
  • Female
  • Glutamate Decarboxylase / immunology
  • Glycated Hemoglobin / analysis
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Republic of Korea / epidemiology
  • Retrospective Studies

Substances

  • Autoantibodies
  • C-Peptide
  • Glycated Hemoglobin A
  • Glutamate Decarboxylase