PDF(Pubmed)
Abstract：
Type 1 diabetes is a chronic disease characterized by abnormal metabolism and hyperglycemia due to insulin deficiency. There is a rapid decline in insulin production due to autoimmune destruction of the pancreatic beta cells. Partial remission (honeymoon phase) of type 1 diabetes is common in children and young adults with newly diagnosed type 1 diabetes. There is temporary restoration of beta cell function such that little or no exogenous insulin is required. Stopping insulin therapy soon after an emergency admission requiring intravenous insulin and subsequent subcutaneous insulin therapy can be frightening for both patient and healthcare provider. Affected patients require education and support during this period. This report describes a case of a 28-year-old man who presented to the emergency department with features of type 1 diabetes and diabetic ketoacidosis. He was treated with intravenous fluids and intravenous insulin and discharged on a subcutaneous insulin regimen. Despite testing positive for several types of islet cell autoantibodies, the patient was able to stop insulin therapy within three months of diagnosis. The patient maintained a self-initiated low-carbohydrate diet, regular weight-reducing exercise, and normal glucose levels without the need for insulin therapy. The honeymoon phase of type 1 diabetes, latent autoimmune diabetes, and ketosis-prone type 2 diabetes are discussed as important differential diagnoses.
摘要：
1型糖尿病是一种慢性疾病，其特征是由于胰岛素缺乏引起的代谢异常和高血糖。由于胰腺β细胞的自身免疫破坏,胰岛素产生迅速下降。1型糖尿病的部分缓解（蜜月期）在新诊断的1型糖尿病的儿童和年轻人中很常见。存在β细胞功能的暂时恢复,使得很少或不需要外源性胰岛素。在需要静脉内胰岛素和随后的皮下胰岛素治疗的紧急入院后不久停止胰岛素治疗可能对患者和医疗保健提供者都是可怕的。在此期间，受影响的患者需要教育和支持。本报告描述了一名28岁男子的病例，该男子向急诊科就诊，具有1型糖尿病和糖尿病酮症酸中毒的特征。他接受了静脉输液和静脉胰岛素治疗，并采用皮下胰岛素方案出院。尽管对几种类型的胰岛细胞自身抗体检测呈阳性，患者能够在诊断后3个月内停止胰岛素治疗.患者保持自我启动的低碳水化合物饮食，有规律的减重锻炼,和正常的葡萄糖水平，而不需要胰岛素治疗。1型糖尿病的蜜月期，隐匿性自身免疫性糖尿病，和酮症倾向的2型糖尿病被讨论为重要的鉴别诊断。
