Fulminant type 1 diabetes: Focusing on triggering factors

Abstract

Fulminant type 1 diabetes (FT1D) is a novel type of type 1 diabetes that is caused by extremely rapid destruction of the pancreatic β cells. Early diagnosis or prediction of FT1D is critical for the prevention or timely treatment of diabetes ketoacidosis, which can be life‐threatening. Understanding its triggers or promoting factors plays an important role in the prevention and treatment of FT1D. In this review, we summarised the various triggering factors of FT1D, including susceptibility genes, immunological factors (cellular and humoural immunity), immune checkpoint inhibitor therapies, drug reactions with eosinophilia and systemic symptoms or drug‐induced hypersensitivity syndrome, pregnancy, viral infections, and vaccine inoculation. This review provides the basis for future research into the pathogenetic mechanisms that regulate FT1D development and progression to further improve the prognosis and clinical management of patients with FT1D.

A case of new-onset Fulminant type 1 diabetes after secondary SARS-CoV-2 infection

“…FT1D has been reported to develop following infection some viruses, such as herpesvirus, HHV-6, cytomegalovirus, and coxsackievirus B3 [ 6 , 7 ] and cellular autoimmunity, such as CD8 + T cell responses [ 8 ]. In this case, we did not find any viral infection other than SARS-CoV-2.…”

“…FT1D is characterised by slightly elevated HbA1c levels, exhaustion of endogenous insulin secretion, and negative results for islet-associated autoantibodies [ 1 ]. The causative factors for FT1D vary, and include susceptibility genes, immunological factors, immune checkpoint inhibitor therapies, viral infections, vaccine inoculation, drug-induced hypersensitivity syndrome and pregnancy [ 2 ]. Understanding these triggers and promoting factors will play an important role in the prevention and treatment of FT1D.…”