94 歳で新規発症，インスリン療法を必要とした緩徐進行 1 型糖尿病の 1 例

We report the case of a 95-year-old woman who had been diagnosed with diabetes mellitus with HbA1c 9.7 % and a fasting blood glucose level of 199 mg/dL at 94 years of age. Despite the administration of oral hypoglycemic therapy for 5 months, her blood glucose was poorly controlled. On admission, we found that her HbA1c was 11.0 %, her casual blood glucose was 394 mg/dL and her glutamic acid decarboxylase antibody titer was 1740 U/mL (ELISA); she was then diagnosed with SPIDDM. While the development of SPIDDM is commonly reported in patients in their 40s to 50s, recent studies showed that around 10 % of elderly patients who developed diabetes were diagnosed with SPIDDM. We searched clinical characteristics of latter-stage elderly patients who developed SPIDDM and found that majority were female and showed reduced insulin secretion with poor glycemic control. It is important to consider the possibility of type 1 diabetes, including SPIDDM, even in elderly patients who have developed diabetes with poor glycemic control.