“Preserved” glucagon secretion in fulminant type 1 diabetes

Abstract

Mixed‐meal tolerance tests were carried out after an overnight fast. Healthy control participants (■), type 1A diabetespatients (○) and fulminant type 1 diabetic patients (▲). Data are presented as the mean ± standard error of the mean.

Prevalence and clinical characteristics of fulminant type 1 diabetes mellitus in Korean adults: A multi‐institutional joint research

“…The HLA DR4‐DQ4 haplotype is common among Japanese patients, but rare in the white population; HLA DRB1*04:05‐DQB1*04:01 haplotype and histidine residue at HLA‐DRβ1 position 13 were associated with fulminant type 1 diabetes mellitus in Korean patients 16 , 17 . Indeed, even in the same fulminant type 1 diabetes mellitus, there were reports of contradictory statements regarding the lowered and maintained levels of glucagon in the Asian population 18 , 19 . However, we were unable to analyze data regarding HLA genotyping in the present study.…”

Beginning of a new era in glucagon research: Breakthrough by the new glucagon assay

“…However, the glucagon response of the same patient became defective at 6 months after the onset. Several research groups responded immediately to this report, and reported “preserved” glucagon response in their studies of patients with fulminant type 1 diabetes, and there were active discussions regarding this topic as well 10–13 . These discussions are clinically important for interaction and dispersal of clinical data, experiences, and knowledge within the medical community.…”

Glucagon secretions are impaired in patients with fulminant type 1 diabetes

“…We have read with great interest the articles by Murase-Mishibe et al 1 and Takahashi et al 2 studying glucagon secretion in fulminant type 1 diabetes patients. Murase-Mishibe et al investigated plasma glucagon levels of fulminant type 1 diabetes patients (n = 3) and acute-onset type 1 diabetes patients (n = 6) during a meal tolerance test, and stated in their study that "no defect in glucagon secretion was observed" in fulminant type 1 diabetes without providing the information for statistical analysis.…”

“…The analysis of the time course data with repeated-measures ANOVA showed that the glucagon levels of fulminant type 1 patients diabetes were significantly lower than that of type 1 diabetes patients (P = 0.003), but similar to PD patients (P = 0.397), consistent with our previous analysis 3 . Given that Takahashi's group previously showed that glucagon secretion in patients with fulminant type 1 diabetes was substantially decreased within 6 months after the onset of the disease 4 , the two groups of investigators discussed whether the duration of the disease could affect the ability of glucagon secretion 1,2 . The duration of the disease of our fulminant type 1 diabetes patients was 1, 6, 12 and 100 months (29.8 -47.0 months).…”