Abstract
Introduction: This report describes a 53-year-old female with slowly progressive insulin-dependent (type 1) diabetes mellitus (SPIDDM) and rheumatoid arthritis (RA) in whom treatment for RA reduced her insulin requirement. Case Description: A routine laboratory examination in March 2004 showed hyperglycemia, which had worsened 5 months later. At this initial examination, her fasting blood glucose and HbAlc levels were 238 mg/dL and 13.1 %, respectively, and she was positive for anti-GAD and anti-IA-2 antibodies. She was diagnosed with SPIDDM and started on insulin therapy, which improved her glycemic control. Following a diagnosis of RA in February 2006, she was started on the immunomodulator leflunomide, which gradually reduced her insulin requirement from 23 U/day to 19 U/day. After starting administration of the tumor necrosis factor (TNF)-alpha inhibitor infliximab in June 2007, she experienced frequent episodes of hypoglycemia. Infliximab was discontinued, and, in December 2008, she started treatment with a combination of methotrexate and leflunomide. She began treatment with adalimumab in April 2015. Her insulin requirement has gradually but progressively decreased to 11 U/day. Her glycemic control remains excellent, with an HbAlc concentration of 5.8 % in August 2015. Conclusion: TNF-alpha inhibitors and/or immunomodulators for RA may preserve the beta cell function, reducing the insulin requirement in patients with SPIDDM.
| Original language | English |
|---|---|
| Pages (from-to) | 25-29 |
| Number of pages | 5 |
| Journal | Journal of the Japan Diabetes Society |
| Volume | 60 |
| Issue number | 1 |
| Publication status | Published - Jan 1 2017 |
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All Science Journal Classification (ASJC) codes
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Endocrinology
Cite this
A case of slowly progressive type 1 diabetes mellitus with reduced insulin requirement during the administration of disease-modifying anti-rhuematic drugs. / Nakamura, Shin; Ide, Hitoshi; Nakamura, Udai; Kitazono, Takanari.
In: Journal of the Japan Diabetes Society, Vol. 60, No. 1, 01.01.2017, p. 25-29.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A case of slowly progressive type 1 diabetes mellitus with reduced insulin requirement during the administration of disease-modifying anti-rhuematic drugs
AU - Nakamura, Shin
AU - Ide, Hitoshi
AU - Nakamura, Udai
AU - Kitazono, Takanari
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Introduction: This report describes a 53-year-old female with slowly progressive insulin-dependent (type 1) diabetes mellitus (SPIDDM) and rheumatoid arthritis (RA) in whom treatment for RA reduced her insulin requirement. Case Description: A routine laboratory examination in March 2004 showed hyperglycemia, which had worsened 5 months later. At this initial examination, her fasting blood glucose and HbAlc levels were 238 mg/dL and 13.1 %, respectively, and she was positive for anti-GAD and anti-IA-2 antibodies. She was diagnosed with SPIDDM and started on insulin therapy, which improved her glycemic control. Following a diagnosis of RA in February 2006, she was started on the immunomodulator leflunomide, which gradually reduced her insulin requirement from 23 U/day to 19 U/day. After starting administration of the tumor necrosis factor (TNF)-alpha inhibitor infliximab in June 2007, she experienced frequent episodes of hypoglycemia. Infliximab was discontinued, and, in December 2008, she started treatment with a combination of methotrexate and leflunomide. She began treatment with adalimumab in April 2015. Her insulin requirement has gradually but progressively decreased to 11 U/day. Her glycemic control remains excellent, with an HbAlc concentration of 5.8 % in August 2015. Conclusion: TNF-alpha inhibitors and/or immunomodulators for RA may preserve the beta cell function, reducing the insulin requirement in patients with SPIDDM.
AB - Introduction: This report describes a 53-year-old female with slowly progressive insulin-dependent (type 1) diabetes mellitus (SPIDDM) and rheumatoid arthritis (RA) in whom treatment for RA reduced her insulin requirement. Case Description: A routine laboratory examination in March 2004 showed hyperglycemia, which had worsened 5 months later. At this initial examination, her fasting blood glucose and HbAlc levels were 238 mg/dL and 13.1 %, respectively, and she was positive for anti-GAD and anti-IA-2 antibodies. She was diagnosed with SPIDDM and started on insulin therapy, which improved her glycemic control. Following a diagnosis of RA in February 2006, she was started on the immunomodulator leflunomide, which gradually reduced her insulin requirement from 23 U/day to 19 U/day. After starting administration of the tumor necrosis factor (TNF)-alpha inhibitor infliximab in June 2007, she experienced frequent episodes of hypoglycemia. Infliximab was discontinued, and, in December 2008, she started treatment with a combination of methotrexate and leflunomide. She began treatment with adalimumab in April 2015. Her insulin requirement has gradually but progressively decreased to 11 U/day. Her glycemic control remains excellent, with an HbAlc concentration of 5.8 % in August 2015. Conclusion: TNF-alpha inhibitors and/or immunomodulators for RA may preserve the beta cell function, reducing the insulin requirement in patients with SPIDDM.
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M3 - Article
AN - SCOPUS:85011949807
VL - 60
SP - 25
EP - 29
JO - Journal of the Japan Diabetes Society
JF - Journal of the Japan Diabetes Society
SN - 0021-437X
IS - 1
ER -