Acute pancreatitis may be a pathogenic factor of fulminant type 1 diabetes mellitus

To the Editor:Fulminant type 1 diabetes mellitus(FT1DM)is characterized by a rapid loss ofβ-cell functions,negative antibody to islet cells,ketoacidosis,and elevated pancreatic enzymes.[1]In a nationwide survey in Japan,elevated pancreatic enzymes and abdominal pain were found in 98%and 70%of patients with ketoacidosisonset FT1DM,respectively.However,abdominal computed tomography(CT)showed no abnormalities.The increased pancreatic enzymes were related to diabetic ketoacidosis.Several Japanese scholars have reported that FT1DM appeared after acute pancreatitis(AP).So far,no such cases have been reported in China.Here,we report two cases of FT1DM following AP,review previous cases,and speculate the relationship between AP and FT1DM.Informed consents were obtained from both patients.