What is it about?
This is a rare case of a 91-year-old man with type 1 diabetes (T1DM), dementia, and suspected myeloperoxidase-ANCA associated vasculitis (AAV) during insulin pump (CSII) treatment. He developed hematuria, inflammation, and worsening glycemic control. Although AAV was strongly suspected, no immunosuppressive therapy was given due to age, diabetes, and family preference. His condition stabilized with insulin adjustment, but ANCA remained positive.
Featured Image
Why is it important?
Oldest reported case of T1DM with ANCA-associated vasculitis. Highlights how aging, autoimmune comorbidities, and diabetes complicate management. Shows that CSII (insulin pump therapy) can still be effective in the oldest-old, but only with strong family support due to cognitive and physical limitations. Emphasizes the need for safe management strategies for very old adults with T1DM as life expectancy increases.
Perspectives
Clinicians must carefully monitor T1DM patients with positive ANCA, even without immediate treatment, as vasculitis can progress. Expanding the use of CSII in the oldest-old requires guidelines, caregiver training, and support systems. More research is needed to determine whether insulin pumps remain safe and effective across all age groups, including those with cognitive decline or frailty.
Prof Takuya Omura
National Center for Geriatrics and Gerontology
Read the Original
This page is a summary of: Oldest‐old type 1 diabetes patient receiving insulin pump treatment with positive myeloperoxidase‐antineutrophil cytoplasmic antibody complication: A case report, Geriatrics and Gerontology International, September 2019, Wiley,
DOI: 10.1111/ggi.13683.
You can read the full text:
Contributors
The following have contributed to this page
