„Double diabetes?” Diagnostic and therapeutic challenges in patient with established type 1 diabetes mellitus, developing features of type 2 diabetes mellitus

Diabetes mellitus encompasses metabolic disorders characterized by elevated blood glucose due to issues with insulin production and function.In type 1 diabetes (T1DM), autoimmune destruction of pancreatic -cells is the primary cause, while in type 2 diabetes (T2DM), the condition arises from a progressive decline in insulin secretion and resistance [1][2][3].This report presents the case of a 32-year-old male diagnosed with T1DM at the age of 12, who, 17 years later, was also diagnosed with T2DM.In 2005, the patient was referred to the hospital with symptoms of lethargy, vomiting, fatigue, polyuria, polydipsia, and elevated fasting blood glucose (serum glucose >600 mg/dL).A diagnosis of T1DM was confirmed based on the presence of autoantibodies, and the treatment with aspart insulin s.c.(Novorapid) at a dosage of 20 IU/ml before meals and isophane insulin s.c.(Insulatard) at a dosage of 30-