Nguyen initially experienced fatigue for several days, assuming it was the flu. However, her symptoms rapidly worsened, prompting an emergency visit to Tam Anh General Hospital in Ho Chi Minh City. Dr. Tran Dong Hai, from the Department of Internal Medicine, suspected a severe metabolic disorder, likely diabetic ketoacidosis (a dangerous buildup of acids in the blood). Tests revealed a blood glucose level of 22.2 mmol/L, nearly 4 times the normal range. Her ketone levels, acids produced when the body lacks insulin, were also significantly elevated, causing critical ketoacidosis. However, Nguyen's HbA1c (a measure of average blood glucose over three months) was normal.

"This is a rare case of fulminant type 1 diabetes, a condition that develops rapidly over a few days and progresses quickly to a critical stage, often without prior symptoms," Dr. Dong Hai explained. He added that fulminant type 1 diabetes is a unique form of type 1 diabetes characterized by rapid destruction of pancreatic beta cells, leading to a sudden insulin deficiency, skyrocketing blood glucose levels, and rapid onset of ketoacidosis. Unlike other forms of diabetes, patients with fulminant type 1 diabetes often have near-normal initial HbA1c levels, but their symptoms emerge abruptly and become severe. Like Nguyen, she had no prior health issues or signs of diabetes before the sudden onset.

Doctors administered intravenous fluids and electrolytes to stabilize Nguyen's cardiovascular system and internal organs. Intravenous insulin was carefully adjusted hourly to lower her blood glucose and control ketoacidosis, preventing potential shock or respiratory failure.

After 48 hours of intensive care, Nguyen regained consciousness, could eat, and walk around her hospital room. With her blood glucose levels returning to a safe range and ketoacidosis improving, she was discharged. She will require long-term insulin therapy to replace the hormone her pancreas no longer produces and will need regular follow-up appointments.

Dr. Dong Hai examines Nguyen during a follow-up appointment. Photo: Tam Anh General Hospital

Dr. Dong Hai examines Nguyen during a follow-up appointment. Photo: Tam Anh General Hospital

Type 1 diabetes is an autoimmune disease where the pancreas stops producing insulin. It usually occurs in younger individuals, who require insulin injections to survive. Type 2 diabetes, more common in older or overweight individuals, occurs when the body still produces insulin but becomes resistant to it. This type can often be managed through diet, exercise, and oral medication.

According to Dr. Hai, individuals at high risk, such as those who are overweight, obese, have a family history of diabetes, or experience persistent fatigue and rapid weight loss, should monitor their health regularly. If unusual symptoms like constant thirst, frequent urination, nausea, abdominal pain, or prolonged fatigue occur, a general internal medicine examination is recommended for comprehensive assessment, including blood glucose and metabolic tests. Early diagnosis and timely intervention can effectively control the disease and reduce the risk of coma and dangerous complications.

Trong Nghia

*The patient's name has been changed.