Fulminant type 1 diabetes mellitus following SARS-CoV-2 infection: a case report

Recent evidence indicates a potential link between SARS-CoV-2 infection and disturbances in glucose metabolism. Several cases of new-onset diabetes, including fulminant type 1 diabetes mellitus (FT1DM), have been reported following SARS-CoV-2 infection or vaccination.

In this case report, we present the clinical course and outcomes of a middle-aged male who developed sudden hyperglycemia and diabetic ketoacidosis following SARS-CoV-2 infection. The patient had no previous history of diabetes and no family history of this disease. Upon admission, the patient had a normal glycohemoglobin level, but the fasting and postprandial C-peptide levels were found to be extremely low, suggesting severe insulin deficiency. These findings were consistent with the diagnosis of FT1DM. The patient was promptly treated with insulin therapy, leading to a rapid improvement in ketoacidosis and hyperglycemia. Despite the successful management of acute complications, the patient’s pancreatic beta cell function did not recover. As a result, the patient received treatment with insulin therapy after being discharged. The first follow-up visit revealed stable blood glucose control, but still with extremely low C-peptide levels.

SARS-CoV-2 infection may lead to the development of FT1DM. This case report raises awareness of early recognition and therapy for FT1DM during the COVID-19 pandemic.