Clinical characteristics of Chinese patients with fulminant type 1 diabetes mellitus: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Zhongce ¹ , DONG Lintao ¹ , PAN Li ¹ , JIN Hongxiu ¹ , ZHANG Jingrong ¹ , LI Lan ² , BI Hongyan ¹ ,  LUO Jingmei ¹ ,  ZHANG Lihua ¹

1. Department of General Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650031, P. R. China;
2. Department of Diabetes Mellitus, The First Affiliated Hospital of Kunming Medical University, Kunming 650031, P. R. China;

Corresponding author：

LUO Jingmei, Email: 185349239@qq.com; ZHANG Lihua, Email: lihuazhang772002@163.com

Keywords：

China; Fulminant type 1 diabetes mellitus; Clinical characteristics; Meta-analysis

DOI：

10.7507/1672-2531.202202068

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the prevalence, clinical characteristics, and prognosis of fulminant type 1 diabetes mellitus (F1DM) in China. Methods The CNKI, WanFang Data, CBM and PubMed databases were searched to collect Chinese F1MD case reports from January 1, 2000 to March 30, 2022. Data analysis was performed using Stata 16.0 software and RevMan 5.3 software. Results A total of 874 cases were included in 233 papers, involving 410 males (46.91%) and 464 females (53.09%). The age of onset was 29.32±1.09 years and the course of disease was 3.74±0.63 days. The BMI was 21.18±0.52 kg/m², HbA1c was 6.58%±0.08%, the level of fasting C-peptide was 0.04±0.010 ng/mL, level of C-peptide 2 h after meal was 0.09±0.020 ng/mL, the level of blood glucose at the doctor’s office was 34.72±2.89 mmol/L, and the level of arterial blood gas pH was 7.09±0.015. Among them, 734 patients had diabetic ketoacidosis (84.55%), 496 patients had infection of the upper respiratory or digestive tract before onset (56.75%), 4 patients died (0.46%), 78 patients were GADA positive, 11 patients were ICA positive, 13 patients were IAA positive, and 109 were pregnant patients (90 fetal deaths, 82.57%). Conclusion Chinese F1DM is a special but common subtype of diabetes. Its characteristics include a relatively young age of onset, devastating islet damage, and rapid progression, and it is often accompanied by severe metabolic disorders, complications, and grim prognosis. Clinicians should pay more attention to F1DM.

Citation： YANG Zhongce, DONG Lintao, PAN Li, JIN Hongxiu, ZHANG Jingrong, LI Lan, BI Hongyan, LUO Jingmei, ZHANG Lihua. Clinical characteristics of Chinese patients with fulminant type 1 diabetes mellitus: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2022, 22(8): 891-895. doi: 10.7507/1672-2531.202202068 Copy

1.	Imagawa A, Hanafusa T, Miyagawa J, et al. A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies. Osaka IDDM Study Group. N Engl J Med, 2000, 342(5): 301-307.
2.	Imagawa A, Hanafusa T, Iwahashi H, et al. Uniformity in clinical and HLA-DR status regardless of age and gender within fulminant type 1 diabetes. Diabetes Res Clin Pract, 2008, 82(2): 233-237.
3.	Imagawa A, Hanafusa T, Awata T, et al. Report of the Committee of the Japan Diabetes Society on the research of fulminant and acute-onset type 1 diabetes mellitus: new diagnostic criteria of fulminant type 1 diabetes mellitus (2012). J Diabetes Investig, 2012, 3(6): 536-539.
4.	王晓晶, 王彤, 于淼, 等. 12例暴发性1型糖尿病临床特征分析. 中国糖尿病杂志, 2018, 26(1): 69-73.
5.	王柏荣, 陆志强, 李晓牧, 等. 新发暴发型1型糖尿病中糖化白蛋白/HbA1C比值与血糖波动幅度的相关性研究. 中华内分泌代谢杂志, 2017, 33(4): 326-329.
6.	Ying L, Ma X, Lu J, et al. Fulminant type 1 diabetes: the clinical and continuous glucose monitoring characteristics in Chinese patients. Clin Exp Pharmacol Physiol, 2019, 46(9): 806-812.
7.	Wang J, Liu BL, Li Z, et al. The characteristics of blood glucose fluctuations in patients with fulminant type 1 diabetes mellitus in the stable stage. Arch Endocrinol Metab, 2018, 62(6): 585-590.
8.	朱文华, 钟绍, 潘颖, 等. 暴发性1型糖尿病7例诊治分析. 内科急危重症杂志, 2017, 23(5): 413-414.
9.	孙致连, 李红晖, 唐平, 等. 暴发性1型糖尿病的临床研究. 广东医学, 2016, 37(z2): 57-58.
10.	谢新荣, 钟慕贤, 黄普好. 新发暴发性1型糖尿病与经典1型糖尿病及成人隐匿性自身免疫性糖尿病的临床特征比较. 中国糖尿病杂志, 2021, 29(10): 754-757.
11.	王毅, 巩纯秀, 曹冰燕, 等. 儿童与青少年暴发性1型糖尿病与经典1型糖尿病的区别. 中华实用儿科临床杂志, 2015, 30(8): 580-584.
12.	Yang D, Zhou Y, Luo S, et al. Clinical characteristics of fulminant type 1 diabetes compared with typical type 1 diabetes: one-year follow-up study from the Guangdong T1DM Translational Medicine Study. J Diabetes Res, 2020, 2020: 8726268.
13.	Moreau C, Drui D, Arnault-Ouary G, et al. Fulminant type 1 diabetes in Caucasian: a report of three cases. Diabetes Metab, 2008, 34(5): 529-532.
14.	张弛, 周智广, 张冬梅, 等. 急骤起病伴胰酶增高的1型糖尿病临床和免疫学特征. 中华医学杂志, 2005, 85(14): 967-971.
15.	Luo S, Zhang Z, Li X, et al. Fulminant type 1 diabetes: a collaborative clinical cases investigation in China. Acta Diabetol, 2013, 50(1): 53-59.
16.	Shimizu I, Makino H, Imagawa A, et al. Clinical and immunogenetic characteristics of fulminant type 1 diabetes associated with pregnancy. J Clin Endocrinol Metab, 2006, 91(2): 471-476.
17.	Liu L, Mao J, Lu Z, et al. Clinical characteristics of fulminant type 1 diabetes associated with pregnancy in China. Endocrine, 2011, 40(3): 408-412.
18.	王娜, 李晓赟, 许永良. 妊娠相关性暴发性1型糖尿病与经典1型糖尿病的对比. 浙江实用医学, 2019, 24(1): 28-29,62.
19.	Matsuura N, Yoshino S, Morisaki H. A case of fulminant type 1 diabetes masquerading acute pancreatitis. J Gen Fam Med, 2017, 18(1): 32-34.
20.	Liu L, Zeng L, Sang D, et al. Recent findings on fulminant type 1 diabetes. Diabetes Metab Res Rev, 2018, 34(1).
21.	Hosokawa Y, Hanafusa T, Imagawa A. Pathogenesis of fulminant type 1 diabetes: genes, viruses and the immune mechanism, and usefulness of patient-derived induced pluripotent stem cells for future research. J Diabetes Investig, 2019, 10(5): 1158-1164.
22.	吴晗, 方兴宇, 于淼, 等. 单中心22例暴发性1型糖尿病临床特征分析. 中华糖尿病杂志, 2018, 10(9): 590-595.
23.	Liu L, Jia W, Wu Y, et al. Plasma glucose to glycated hemoglobin ratio: method of differentiating fulminant type 1 diabetes from diabetic ketoacidosis. Ann Endocrinol (Paris), 2019, 80(1): 16-20.

1. Imagawa A, Hanafusa T, Miyagawa J, et al. A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies. Osaka IDDM Study Group. N Engl J Med, 2000, 342(5): 301-307.
2. Imagawa A, Hanafusa T, Iwahashi H, et al. Uniformity in clinical and HLA-DR status regardless of age and gender within fulminant type 1 diabetes. Diabetes Res Clin Pract, 2008, 82(2): 233-237.
3. Imagawa A, Hanafusa T, Awata T, et al. Report of the Committee of the Japan Diabetes Society on the research of fulminant and acute-onset type 1 diabetes mellitus: new diagnostic criteria of fulminant type 1 diabetes mellitus (2012). J Diabetes Investig, 2012, 3(6): 536-539.
4. 王晓晶, 王彤, 于淼, 等. 12例暴发性1型糖尿病临床特征分析. 中国糖尿病杂志, 2018, 26(1): 69-73.
5. 王柏荣, 陆志强, 李晓牧, 等. 新发暴发型1型糖尿病中糖化白蛋白/HbA1C比值与血糖波动幅度的相关性研究. 中华内分泌代谢杂志, 2017, 33(4): 326-329.
6. Ying L, Ma X, Lu J, et al. Fulminant type 1 diabetes: the clinical and continuous glucose monitoring characteristics in Chinese patients. Clin Exp Pharmacol Physiol, 2019, 46(9): 806-812.
7. Wang J, Liu BL, Li Z, et al. The characteristics of blood glucose fluctuations in patients with fulminant type 1 diabetes mellitus in the stable stage. Arch Endocrinol Metab, 2018, 62(6): 585-590.
8. 朱文华, 钟绍, 潘颖, 等. 暴发性1型糖尿病7例诊治分析. 内科急危重症杂志, 2017, 23(5): 413-414.
9. 孙致连, 李红晖, 唐平, 等. 暴发性1型糖尿病的临床研究. 广东医学, 2016, 37(z2): 57-58.
10. 谢新荣, 钟慕贤, 黄普好. 新发暴发性1型糖尿病与经典1型糖尿病及成人隐匿性自身免疫性糖尿病的临床特征比较. 中国糖尿病杂志, 2021, 29(10): 754-757.
11. 王毅, 巩纯秀, 曹冰燕, 等. 儿童与青少年暴发性1型糖尿病与经典1型糖尿病的区别. 中华实用儿科临床杂志, 2015, 30(8): 580-584.
12. Yang D, Zhou Y, Luo S, et al. Clinical characteristics of fulminant type 1 diabetes compared with typical type 1 diabetes: one-year follow-up study from the Guangdong T1DM Translational Medicine Study. J Diabetes Res, 2020, 2020: 8726268.
13. Moreau C, Drui D, Arnault-Ouary G, et al. Fulminant type 1 diabetes in Caucasian: a report of three cases. Diabetes Metab, 2008, 34(5): 529-532.
14. 张弛, 周智广, 张冬梅, 等. 急骤起病伴胰酶增高的1型糖尿病临床和免疫学特征. 中华医学杂志, 2005, 85(14): 967-971.
15. Luo S, Zhang Z, Li X, et al. Fulminant type 1 diabetes: a collaborative clinical cases investigation in China. Acta Diabetol, 2013, 50(1): 53-59.
16. Shimizu I, Makino H, Imagawa A, et al. Clinical and immunogenetic characteristics of fulminant type 1 diabetes associated with pregnancy. J Clin Endocrinol Metab, 2006, 91(2): 471-476.
17. Liu L, Mao J, Lu Z, et al. Clinical characteristics of fulminant type 1 diabetes associated with pregnancy in China. Endocrine, 2011, 40(3): 408-412.
18. 王娜, 李晓赟, 许永良. 妊娠相关性暴发性1型糖尿病与经典1型糖尿病的对比. 浙江实用医学, 2019, 24(1): 28-29,62.
19. Matsuura N, Yoshino S, Morisaki H. A case of fulminant type 1 diabetes masquerading acute pancreatitis. J Gen Fam Med, 2017, 18(1): 32-34.
20. Liu L, Zeng L, Sang D, et al. Recent findings on fulminant type 1 diabetes. Diabetes Metab Res Rev, 2018, 34(1).
21. Hosokawa Y, Hanafusa T, Imagawa A. Pathogenesis of fulminant type 1 diabetes: genes, viruses and the immune mechanism, and usefulness of patient-derived induced pluripotent stem cells for future research. J Diabetes Investig, 2019, 10(5): 1158-1164.
22. 吴晗, 方兴宇, 于淼, 等. 单中心22例暴发性1型糖尿病临床特征分析. 中华糖尿病杂志, 2018, 10(9): 590-595.
23. Liu L, Jia W, Wu Y, et al. Plasma glucose to glycated hemoglobin ratio: method of differentiating fulminant type 1 diabetes from diabetic ketoacidosis. Ann Endocrinol (Paris), 2019, 80(1): 16-20.

Chinese Journal of Evidence-Based Medicine

Clinical characteristics of Chinese patients with fulminant type 1 diabetes mellitus: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content