August 28, 2013

Duration of T1D before DKA Strikes


fulminantFulminant diabetes describes the rapid onset of T1D. The symptoms of T1D may have been present long before DKA strikes. This period of time has been estimated in a study published in Japanese Clinical Medicine

Fulminant T1D often results in undetectable c-peptide levels, at diagnosis. This means that the autoimmune attack destroying the beta cells likely had been at work for some time. For this study, diagnosis is  established as diabetic ketoacidosis or DKA.

An abrupt increase in glucose, HbA1c and glycated albumin (GA) might increase along with duration of symptoms in people that are diagnosed with T1D abruptly.

This study analyzed 4 patients who had a rapid onset of T1D. These patients were previously followed for T2D and therefore the previous HbA1c levels were measured before T1D rapid onset.

The percents of the estimated duration of symptoms were calculated from HbA1c in all 4 patients and glycated albumin in 2 patients.

If a person has T2D, the managing physician would want to check HbAqc about every 3 months. According to this study, those patients had an increase in HbA1c about 88% in 3 months.

Glycated albumin is a measure of the average glucose concentration over approximately 2-3 weeks. Of those patients, 2 had previous glycated albumin measurements. Upon T1D diagnosis, the GA rose 122% in 3 months.

Unlike the highly regulated world of the TSA, the arrival of T1D isn’t listed on an arrival or departure board. The arrival time of T1D is not scheduled. This study shows that even the best of us can miss it. Once we’ve made our flight, traveling is a lot less stressful .

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