Acute Pancreatitis Causing Insulin-Dependent Diabetes Mellitus

Impaired glucose tolerance is a well-known complication of acute pancreatitis. However, transition from acute pancreatitis to insulin-dependent diabetes mellitus (IDDM) is rare. Recently we encountered a case of IDDM due to diabetic ketoacidosis (DKA) subsequent to acute pancreatitis. We report the present case and also discuss several studies on this pathological condition. The patient was a 38-year-old woman who visited a nearby hospital with high fever and epigastric pain. Hematological and X-ray examinations indicated that the patient was suffering from acute pancreatitis. On the sixth hospital day, she was transferred to this hospital due to hyperglycemia, consciousness disorder and metabolic acidosis. Insulin therapy and continuous hemodialysis were effective in the improvement of these symptoms. However, insulin therapy was necessary after the amelioration of the pancreatitis. Although the patient has a family history of diabetes mellitus, she has no past history of this disease and her HbAlc level was within the normal range. Furthermore, her blood glucose level was normal at the onset of the pancreatitis. A diagnosis of IDDM was made because the blood and urinary C-peptide levels measured at the onset of DKA were low, and the β cell functions were suppressed.