SLOW ONSET TYPE 1 DIABETES ASSOCIATED WITH PREGNANCY: A CASE REPORT

Abstract

: GESTATIONAL DIABETES MELLITUS (GDM) IS DEFINED AS ANY GLUCOSE INTOLERANCE WITH FIRST RECOGNITION DURING PREGNANCY AND IT CAN BE REVELATORY OF UNDERLYING BETA-CELL DYSFUNCTION, WHICH CONFERS AN INCREASED RISK FOR LATER DEVELOPMENT OF DIABETES, BOTH TYPE 1 DIABETES (T1DM) AND TYPE 2 DIABETES (T2DM), THE LAST BEING THE MOST COMMON. A SUBGROUP OF PATIENTS WITH GDM, ESPECIALLY THOSE WITH AUTOANTIBODY POSITIVITY DURING AND AFTER PREGNANCY, MAY EVOLVE, OFTEN SEVERAL YEARS AFTER PREGNANCY, INTO CASES OF LATENT AUTOIMMUNE DIABETES OF ADULTHOOD (LADA), THE ‘’SLOWLY PROGRESSIVE AUTOIMMUNE DIABETES”. WE REPORT THE CASE OF A 29-YEAR-OLD CAUCASIAN WOMAN, WHO FIRST PRESENTED TO OUR HOSPITAL IN OCTOBER 2014 FOR A POSTPARTUM FOLLOW-UP OF A GDM, WHICH WAS DIAGNOSED SHORTLY BEFORE DELIVERY AT 36TH WEEK OF GESTATION, DUE TO FETAL DISTRESS. SHE RECEIVED METFORMIN ASSOCIATED WITH BASAL INSULIN THERAPY. SUBSEQUENTLY SHE CONVERTED TO BASAL BOLUS INSULIN THERAPY. RECENTLY, THE PATIENT PRESENTED WITH POOR METABOLIC CONTROL (11.5% HBA1C) AND HAS DEVELOPED DIABETIC PAPILLOPATHY. THE SPECIFIC PHENOTYPIC FEATURES AND THE MANAGEMENT OF LATENT AUTOIMMUNE DIABETES IN ADULTS ARE CHALLENGING AND FURTHER RESEARCH SHOULD BE PERFORMED.