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'Disappearing diabetes' - resolution of apparent Type 1 diabetes in a patient with AIDS and cytomegalovirus (CMV) infection

Evans, E. M., Nye, F., Beeching, Nicholas ORCID: https://orcid.org/0000-0002-7019-8791 and Gill, Geoff (2005) ''Disappearing diabetes' - resolution of apparent Type 1 diabetes in a patient with AIDS and cytomegalovirus (CMV) infection'. Diabetic Medicine, Vol 22, Issue 2, pp. 218-220.

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Abstract

A 30-year-old African female with established acquired immunodeficiency syndrome (AIDS) and no history of diabetes, presented in severe diabetic ketoacidosis (DKA). Blood pH was 6.96, serum bicarbonate 5 mmol/l, plasma glucose (PG) 33.0 mmol/l, and urine heavily positive for ketones. She responded to standard treatment and was established on twice-daily subcutaneous insulin. Four months later her insulin was stopped because of hypoglycaemic attacks on small doses. A glucose tolerance test (GTT) at 6 months postdiagnosis was normal (fasting PG 4.4 mmol/l and 2 h PG 7.5 mmol/l), and at 12 months random PG was 4.1 mmol/l and HbA(1c) 4.3%. The onset of her apparent Type 1 diabetes coincided with an HIV-associated cytomegalovirus (CMV) infection, and a reversible 'CMV insulitis' may be an explanation. Alternatively, the patient may have had what has recently been described as 'atypical diabetes' in African or Afro-Caribbean diabetic patients. Here resolution of diabetes may occur after presentation, though complete return to normoglycaemia after true DKA is very unusual.

Item Type: Article
Uncontrolled Keywords: hiv infection; aids; diabetes mellitus; type 1 diabetes diabetic ketoacidosis; cytomegalovirus; ketoacidosis; remission mellitus
Subjects: WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.5 Complications
WK Endocrine System > WK 810 Diabetes mellitus
WK Endocrine System > WK 840 Diabetes as a complication in other conditions
Faculty: Department: Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI): https://doi.org/10.1111/j.1464-5491.2005.01364.x
Depositing User: Ms Julia Martin
Date Deposited: 01 Nov 2011 16:20
Last Modified: 09 Sep 2019 06:26
URI: https://archive.lstmed.ac.uk/id/eprint/1877

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