A Case of Fulminant Type 1 Diabetes Associated With Painless Thyroiditis

Abstract

ent, and the herbal combination appears to slowly improve the FBG concentrations over a period of continuous use. Surprisingly, this effect was rapidly reversed when the treatment ceased, as blood glucose retuned to pretreatment levels within 15-20 days. Those subjects who started to take the herbal remedy again after the withdrawal period showed a more rapid decline in their FBG concentrations than when they first started the treatment. It is unclear from this study whether the FBG would return to euglycemia over a longer period of time, but it appears that the rate of decline slows and may plateau before this was reached.This study strongly suggests that this combination of traditional Chinese herbs, together with chromium, may be effective in improving glycemic control in people diagnosed with type 2 diabetes. The mechanism of action remains unclear and may be a combination of an increase in insulin responsiveness and glucose uptake. The relative importance of the individual component herbs is also unknown, and we are undertaking further studies to investigate this. MECHELE COLLINS, BSC (HONS)

Painless Thyroiditis and Fulminant Type 1 Diabetes Mellitus in a Patient Treated with an Immune Checkpoint Inhibitor, Nivolumab

“…However, the involvement of T-cell autoimmunity in this disease has also been reported previously (Taniguchi et al 2001(Taniguchi et al , 2005Shimada et al 2002a, b). Moreover, Hamasaki et al (2006) reported that fulminant type 1 diabetes and painless thyroiditis presented simultaneously in a 47-year-old woman without treatment of the immune checkpoint inhibitor. Painless thyroiditis is generally considered to be an autoimmune disorder (Dayan and Daniels 1996).…”

“…Painless thyroiditis is generally considered to be an autoimmune disorder (Dayan and Daniels 1996). Therefore, the case reported by Hamasaki et al (2006) suggested participation of autoimmune mechanisms at the onset of fulminant type 1 diabetes. Occurrence of fulminant type 1 diabetes mellitus was also observed after nivolumab-induced painless thyroiditis in the present case.…”