SUN-275 Azathioprine for Tertiary Prevention of Diabetes in Patients with Newly Diagnosed Type 1 Diabetes

Background: Co-occurrence of type 1 diabetes (T1DM) and autoimmune hepatitis (AIH) is rare 1 . Older studies on azathioprine for tertiary prevention of T1DM show mixed results and often intolerable side effects. 2,3 There are no recent studies or case reports on the effect of azathioprine on the tertiary prevention of T1DM. Clinical Case: A 6 y.o. M with recently diagnosed AIH on prednisolone taper (15 mg BID; 2mg/kg/day) presented to pediatric endocrinology due to abnormal labs including glucose of 684 mg/dL. He endorsed abdominal pain and polydipsia but was otherwise well. Further workup showed VBG: pH 7.4, bicarbonate 26.7, glucose 653mg/dL, C-peptide 4.7, HgbA1c 6.6%. He was given IV fluids and started on basal/bolus insulin regimen. He was positive for 5/5 diabetes related autoantibodies: Glutamic Acid Decarboxylase Antibody: >250 IU/mL [Ref Range: