Complex of Hybrid Diabetes Mellitus With Severe Insulin Resistance and Cerebrovascular Complications: A Case Report

Abstract Some type 1 diabetes mellitus (T1DM) patients develop features of insulin resistance, typically seen in type 2 diabetes mellitus, leading to a condition termed hybrid diabetes mellitus (HDM). We present a case of a 30-year-old female diagnosed with HDM and cardiovascular complications. She had a history of T1DM from the age of 7 years and presented with acute right-sided limb weakness. She had comorbidities, including hypertension, polycystic ovarian syndrome, hypothyroidism, and a high Body Mass Index (37 kg/m 2 ). Initial evaluations revealed elevated blood pressure, pulse rate, thrombocytosis, homocysteine level, and hemoglobin A1c. Magnetic resonance imaging showed a completely blocked carotid artery and cardiological assessments indicated mild left ventricular hypertrophy and diastolic dysfunction. Glutamic acid decarboxylase antibodies were positive, and C-peptide was absent, confirming T1DM with insulin resistance HDM. Treatment involved anticoagulants, antiplatelets, statins, and supportive care. The patient showed significant clinical improvement, although surgery was not viable due to completely blocked vessels.