Age: 39.0
Sex: M
Vaccine: YF
Symptoms: Loss of consciousness, Mechanical ventilation, Neuropathy peripheral, Pneumonia, Polydipsia
Clinical narrative: Service member (SM) was in his usual state of excellent health prior to Aug 2006. He was diagnosed with Type 1 Diabetes Mellitus (T1DM) in Sep 2007. Looking back, SM recalls developing symptoms of hyperglycemia sometime between Aug and Dec 2006. Initially, his symptoms were subtle and he did not feel he was "sick", but his symptoms gradually increased and led to his diagnosis of T1DM in Sep 2007. SM received Yellow Fever vaccine in May 2006 and influenza vaccine in Dec 2006, which receipt of Typhoid vaccine in August 2007, shortly before his diagnosis. He denies any unusual or prolonged reactions within the first week following vaccine receipt. He does not recall any viral-type symptoms just prior to or on the days of vaccine receipt. Symptoms SM reports for months, maybe even a year prior to diagnosis were polyuria, polydipsia, fatigue, and weight loss. He had been losing weight by following the ATKIN's diet for a couple of years prior to symptom onset. His baseline weight in 2006 was about 200 pounds. At the time of diagnosis, his weight was down to about 160 lbs per her Med Records. SM did not experienced changes in sexual function until about 2 months before diagnosis, and he did not experience any visual changes until the week before diagnosis. In Sept 2007, SM was staying in a hotel during his week-end drill. After his wife attempted to call him and did not get an answer, she called the hotel front desk, who called the ambulance. The patient was unconscious and was admitted to hospital between 9/12/2007 and 9/19/2007. He was did not regain consciousness for 3 days and was placed on a ventilator. He believes his serum glucose level was >750 and he was in Diabetic Ketoacidosis (DKA). He suffered from renal insufficiency and almost went on dialysis. During his hospitalization, he developed pneumonia. During his hospitalization, he received hydration and electrolyte replacement, and insulin, as well as diabetes self management training were initiate. He was discharged on once daily LANTUS with additional supplementation for hyperglycemia using HUMALOG. Since diagnosis, SM has been followed through local civilian health care providers. He has been on an insulin pump for about 1 year. Following his diagnosis of T1DM, he had been diagnosed with peripheral neuropathy, ED, skin cancer, hyperlipidemia, right shoulder rotator cuff tear, and left knee ACL tear. Around the time of diagnosis, SM was told he had diabetic changes in left eye, which had later been noted to have resolved at a follow-up exam 2 months later. SM denies a history of elevated glucose or blood pressure levels or history of hypertension prior to T1DM diagnosis. He does not recall a history of a recent infection or symptoms of cough, fever, sinus symptoms, congestion or diarrhea prior to his diagnosis. He was active with sports and met military weight requirements prior to diagnosis. SM has a sister with T1DM who was diagnosed at age 3. (He says he was tested around 1976 to see if the was at risk to develop T1DM and his mother was told he was not at risk.)