Clinical characteristics of pregnancy related fulminant type 1 diabetes

Onset occurred during pregnancy in three cases (at 24, 37, and 39 weeks of gestation, respectively) and postpartum in two cases (6 days and 13 days postpartum). Among the five PF patients, four presented with significant hyperglycemic symptoms (polydipsia, polyuria, dry mouth), three were accompanied by gastrointestinal symptoms, two had preceding upper respiratory tract infections, two exhibited fetal distress, and one experienced intrauterine fetal demise.

Compared with T1DM, PF was characterized by a more rapid and significant decline in islet function and more accelerated disease progression. Conclusion: PF is characterized by an abrupt onset, marked hyperglycemia, relatively low HbA1c levels, and severe ketoacidosis, posing significant risks to both mother and infant. Early identification based on blood glucose, HbA1c, and pancreatic islet function indicators is crucial in clinical practice, along with the prompt initiation of insulin therapy and multidisciplinary collaboration to improve pregnancy outcomes.