Dramatic Improvement of Glycemic Control by Promptly Starting Steroid Therapy at an Early Stage of Autoimmune Pancreatitis in a Subject with Type 2 Diabetes

• Published in: Internal Medicine 2019/12/01, Vol.58(23), pp.3427-3431
• Main Authors: Irie, Shintaro, Anno, Takatoshi, Uji, Emiko, Nakamura, Jun, Kawasaki, Fumiko, Kawamoto, Hirofumi, Kaku, Kohei, Kaneto, Hideaki
• Format: Article
• Language: English
• Subjects: Aged; autoimmune pancreatitis; Autoimmune Pancreatitis - drug therapy; Blood Glucose - metabolism; Case Report; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Drug Administration Schedule; Glucocorticoids; Glucocorticoids - administration & dosage; Glucose; Humans; Hypoglycemic Agents - therapeutic use; Insulin; Insulin - therapeutic use; insulin secretory capacity; Internal medicine; Male; Pancreatitis; Prednisolone - administration & dosage; steroid therapy; Steroids; Treatment Outcome
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.3198-19

Glucocorticoid therapy is effective for treating autoimmune pancreatitis, but autoimmune pancreatitis itself and steroid therapy aggravate glycemic control. A 77-year-old man with type 2 diabetes was consulted due to aggravation of glycemic control. He was diagnosed with autoimmune pancreatitis. We promptly started glucocorticoid therapy for autoimmune pancreatitis and insulin therapy for glycemic control. Subsequently, both pancreatitis and diabetes were markedly ameliorated. After stopping glucocorticoid therapy, good glycemic control continued with diet therapy alone. Starting glucocorticoid therapy at an early stage of autoimmune pancreatitis is very important for preserving the insulin secretory capacity and improving glycemic control.