Fulminant type l diabetes mellitus (FT1DM) is a subtype of T1DM with acute onset, but data on its feature of glucose profiles is limited. This study aimed to compare the glucose profiles between newly diagnosed patients with FT1DM and typical type 1 diabetes mellitus (TT1DM). From Sep. 2013 to Oct. 2019, newly diagnosed patients who fulfilled respective criteria of FT1DM and TT1DM in our department were included in the analysis. After diabetic ketoacidosis correction, the MiniMed Paradigm 722 insulin pump was used to monitor the real-time glucose levels for 3 consecutive days. Demographic and clinical data at the onset were collected. CGM metrics were compared between the two groups. A total of 8 patients (female, 50%) were diagnosed as FT1DM with 2 of them developed diabetes during pregnancy, and 20 patients (female, 60%) were diagnosed as TT1DM. At the onset, patients in FT1DM group had higher age (30.5 [24.0, 38.0] vs. 21.0 [9.5, 32.3] yrs, P<0.01), lower level of HbA1c (6.31 ± 0.58 vs. 11.73 ± 3.47%, P<0.001) and C-peptide (0h, 0.04 [0.04, 0.04] vs. 0.06 [0.04, 0.11] nmol/L; 2h, 0.04 [0.04, 0.04] vs. 0.19 [0.14, 0.27] nmol/L, all P<0.05) than those with TT1DM. Larger glycemic fluctuation was observed in FT1DM group with significantly higher level of SD (3.2 ± 0.8 vs. 2.5 ± 0.8 mmol/L, P<0.05), CV (36.14 ± 7.40 vs. 29.55 ± 5.69%, P=0.02) and MAGE(8.10 ± 1.46 vs. 6.25 ± 1.92 mmol/L, P=0.02). The five key metrics were similar between the two groups: mean glucose (8.5 [7.7, 9.1] vs. 7.8 [7.1, 9.0]mmol/L), glucose management indicator (6.9 [6.5, 7.4] vs. 6.5 [6.1, 7.3]%), time spent in range 3.9-10.0mmol/L (72.6 [60.8, 79.5] vs. 78.6 [69.1,89.8]%), time spent <3.9 mmol/L (1.2 [0.1, 4.1] vs. 0.1 [0.0, 2.5]%) and time spent >10.0mmol/L (27.2 [16.4, 35.1] vs. 18.7 [8.7, 28.9]%) (all P>0.05).Newly diagnosed patients with FT1DM had significantly larger glycemic fluctuation than those with TT1DM even with a well-controlled inpatient management.

Disclosure

L. Gan: None. B. Lin: None. Y. Zhou: None. J. Yan: None. W. Xu: None. D. Yang: None. S. Luo: None. X. Zheng: None. H. Liang: None. B. Yao: None. J. Weng: None.

Funding

National Key Research and Development Program of China (2017YFC1309600); Natural Science Foundation of Guangdong Province (2018A030313251)

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