Acute-onset autoimmune type 1 diabetes presenting with diabetic ketoacidosis in an obese adult.
David Kweku Aseda Donkor, Venkata Siva Dilisha Chandanala, Toluwalase Akinfisoye et al.
✦ AI-curated · Sources linked
Case in brief
A 51-year-old obese man presented with severe diabetic ketoacidosis, characterized by hyperglycemia of 1297 mg/dL and metabolic acidosis. Laboratory tests revealed strong positivity for glutamic acid decarboxylase antibodies and very low C-peptide levels, indicating significant insulin deficiency. The patient was treated with standard DKA management and subsequently discharged on insulin therapy, highlighting the atypical presentation of autoimmune type 1 diabetes in adults.
Diagnostic / clinical pearl
In adults with new-onset diabetes and significant insulin deficiency, measuring islet autoantibodies and C-peptide is crucial to prevent misclassification and ensure appropriate insulin therapy.
Why it matters
This case underscores that obesity does not rule out autoimmune type 1 diabetes, emphasizing the need for comprehensive diagnostic evaluation in atypical presentations.