Long-Term Discontinuation of Insulin Treatment in a Type 1 Diabetic Patient
A case for late autoimmune diabetes of the adult?
- Jan Ruxer, MD, PHD,
- Michal Mozdzan, MD,
- Leszek Czupryniak, MD, PHD and
- Jerzy Loba, MD, PHD
- From the Diabetology Department, Medical Unviersity of Lodz, Lodz, Poland
Type 1 diabetes is a well-defined condition requiring life-saving insulin replacement therapy immediately after diagnosis (1). It is also a well-known fact from the natural course of the disease that soon after the insulin therapy has been initiated, insulin requirements decrease, sometimes rapidly, and patients who stopped taking insulin shortly after diabetes diagnosis have been reported (2). However, this so-called “honeymoon period” usually starts several weeks after the diagnosis and rarely exceeds several months’ duration. It is believed, however, and has been unfortunately shown in the past, e.g., during wartime, that insulin discontinuation in a long-standing type 1 diabetic patient poses a serious threat to health and life (3,4). We describe a case of a patient with a definite diagnosis of autoimmune diabetes who, 2 years after having been diagnosed with diabetes, stopped insulin treatment for a period of 17 months and did not develop ketoacidosis.
In April 2000, a 19-year-old woman was admitted to the Metabolic Diseases Department due to profound weakness, dizziness, and increased thirst, as well as a 10-kg weight loss in 6 months. The symptoms occurred several months earlier but became more severe within the previous 8 weeks.
The patient was diagnosed with type 1 diabetes in November 1998. Her symptoms at the time gradually developed for 4 months and included increased thirst, …
