年森、他：慢性膵炎合併1型糖尿病南予医誌 Vol.15 No. １ 2014－57－Abstract A 51-year-old man was referred to the department of ophthalmology at our hospital because of general malaise, low level of vision, and thirst from the end of 2012. Blood examinations indicated that HbA1c was 15.9% and blood sugar (BS) was 819 mg/dL. Fur-thermore, the blood and urine tests revealed a low level of endogenous insulin, anti-GAD antibody 2.4 U/mL, a normal level of ketone bodies, and plasma hyperosmolarity. Hyperos-molar hyperglycemic syndrome (HHS) was diagnosed. Abdominal CT images revealed the complication of chronic pancreatitis. After admission, we started treatment with an intrave-nous drip injection of saline and a continuous intravenous insulin infusion. After BS levels improved, intensive insulin therapy was started. However, the patient had fasting hypogly-cemia and postprandial hyperglycemia. Finally the BS transited from 150 mg/dL to 200 mg/dL. This patient’s experience suggests that ketoacidosis might not occur even if insufciency of endogenous insulin exists when the condition is associated with endocrine and exocrine pancreatic insufciency.（Nan-yo Med J 2014; 15: 49-57.）Type 1 diabetes associated with chronic pancre-atitis and development of hyperosmolar hyper-glycemic syndrome: a case reportShinichi TOSHIMORI, Tohru EGUCHI, Shozo MIYAUCHI Department of Internal MedicineUwajima City HospitalGoten-machi, Uwajima, Ehime 798-8510, Japan
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