Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To the Editor: Type 1 diabetes mellitus (DM) is caused by severe insulin deficiency that typically results from autoimmune destruction of pancreatic β-cells, although in some cases (classified as "idiopathic") there is no evidence of autoimmunity.1 Recently, a novel etiology of the disease has been described as nonautoimmune fulminant type 1 DM,2 which involves abrupt onset of insulin-deficient hyperglycemia, high serum pancreatic enzyme concentrations, and neither diabetes-related autoantibodies nor evidence of insulitis in pancreatic biopsy specimens. We report a case of rapid-onset type 1 DM with diabetic ketoacidosis (DKA), for which the clinical course was precisely documented. Interestingly, the onset of diabetes coincided with development of hemolytic anemia due to carbamazepine-induced cold agglutinin disease.
Sekine N, Motokura T, Oki T, Umeda Y, Sasaki N, Hayashi M, Sato H, Fujita T, Kaneko T, Asano Y, Kikuchi K. Rapid Loss of Insulin Secretion in a Patient With Fulminant Type 1 Diabetes Mellitus and Carbamazepine Hypersensitivity Syndrome. JAMA. 2001;285(9):1153-1154. doi:10.1001/jama.285.9.1153