Abstract:

Fulminant type 1 diabetes mellitus (FT1DM) is characterized by rapid and irreversible destruction of islet cells and rapid development of diabetic ketoacidosis (DKA). Viral infection within two weeks is closely associated with its onset. This paper reports a case of a young male patient who developed DKA almost 2 weeks after SARS-CoV-2 infection. The patient had no history of diabetes, and he developed severe DKA, combined with viral myocarditis, severe pneumonia, and acute renal failure. After admission to the hospital for continuous renal replacement therapy (CRRT), mechanical ventilation, supplementation of large amounts of fluid and intravenous insulin application, correction of electrolyte and acid-base balance disorders, nourishment of the heart muscle, and other active treatments, the patient’s blood sugar was well controlled, DKA was corrected, and vital signs and the internal environment gradually stabilized. Insulin-enhanced therapy continued after hospitalization. The present case suggests that FT1DM may develop after SARS-CoV-2 infection, and is prone to combined multi-organ impairment, severe disease, and poor prognosis. Timely multi-disciplinary joint intervention can improve survival.

Key words: Fulminant type 1 diabetes mellitus, COVID-19, SARS-CoV-2, Multiple organ damage, Multidisciplinary joint treatment