Type 1 diabetes mellitus in combination with granulomatosis with polyangiitis: a clinical case report
https://doi.org/10.14341/DM13389
Abstract
We report a rare clinical case of the coexistence of two autoimmune diseases: type 1 diabetes mellitus and granulomatosis with polyangiitis. Both conditions share a common target — small-caliber blood vessels — which contributes to overlapping mechanisms of tissue injury, progressive microcirculatory impairment, and the development of multiple diabetes-related complications. The requirement for systemic glucocorticosteroids as pathogenetic therapy represents a particular therapeutic challenge: while indispensable for the control of vasculitis, they simultaneously impair glucose metabolism, exacerbate glycemic variability, and slow wound healing. The concurrence of these pathologies is exceedingly uncommon and typically manifests as a syndrome of mutual aggravation with a poor clinical prognosis. In cases of lower-limb ulcerations, lesions should be regarded as potentially chronic and treatment-refractory, thereby raising the question of amputation. Comprehensive monitoring, including advanced glycemic control technologies and regular evaluation of vasculitis activity, is essential in such patients. This case highlights the clinical features, management strategy, and pathogenetic mechanisms underlying complications, underscoring the need for individualized, multidisciplinary approaches.
About the Authors
A. N. Zvyagintseva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Anastasia N. Zvyagintseva
11 Dm. Ulyanova street, 117292 Moscow
Competing Interests:
none
D. V. Ivanova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Daria V. Ivanova
Moscow
Competing Interests:
none
S. V. Sergeeva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Svetlana V. Sergeeva - MD.
Moscow
Competing Interests:
none
A. Y. Tokmakova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Alla Y. Tokmakova - MD, PhD.
Moscow
Competing Interests:
none
G. R. Galstyan
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Gagik R. Galstyan - MD, PhD, Professor.
Moscow
Competing Interests:
none
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2. Figure 2. Dynamics of hemoglobin levels during treatment. | |
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3. Figure 3. Dynamics of leukocyte counts during treatment. | |
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4. Figure 4. Dynamics of platelet counts during treatment. | |
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For citations:
Zvyagintseva A.N., Ivanova D.V., Sergeeva S.V., Tokmakova A.Y., Galstyan G.R. Type 1 diabetes mellitus in combination with granulomatosis with polyangiitis: a clinical case report. Diabetes mellitus. 2026;29(2):224-230. (In Russ.) https://doi.org/10.14341/DM13389
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