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Ketosis prone diabetes

Hala Hussein, Fidaa Ibrahim, Eugène Sobngwi, Jean François Gautier, Philippe Boudou
OBJECTIVES: Zinc transporter 8 (ZnT8) is specifically expressed in the pancreatic β-cell and is more restricted in its tissue distribution than other auto-antigens as glutamic acid decarboxylase 65 (GAD65) and insulinoma-associated antigen-2 (IA2). ZnT8 autoantibodies (ZnT8A) assessment allows identifying rapid progression to clinical onset of the disease. We evaluated the prevalence of ZnT8A in adults of different ethnic and phenotypic groups and analyzed its potential utility as additional marker of autoimmunity in daily practice...
June 27, 2016: Clinical Biochemistry
J-L Nguewa, E Lontchi-Yimagou, F Agbelika, M AitDjoudi, P Boudou, S Choukem, E Sobngwi, J-F Gautier
BACKGROUND AND OBJECTIVES: Peripheral tissue resistance to insulin action is a characteristic of type 2 diabetes mellitus (T2DM). It has also been reported that some chronic viral infections can contribute to insulin resistance. Human herpesvirus (HHV)-8 infection has been detected in T2DM patients in previous studies. Our study investigated whether the presence of the virus is associated with insulin resistance in patients with ketosis-prone type 2 diabetes (KPD), as reported with other viruses...
June 1, 2016: Diabetes & Metabolism
Ebenezer A Nyenwe, Abbas E Kitabchi
The prognosis of diabetic ketoacidosis has undergone incredibly remarkable evolution since the discovery of insulin nearly a century ago. The incidence and economic burden of diabetic ketoacidosis have continued to rise but its mortality has decreased to less than 1% in good centers. Improved outcome is attributable to a better understanding of the pathophysiology of the disease and widespread application of treatment guidelines. In this review, we present the changes that have occurred over the years, highlighting the evidence behind the recommendations that have improved outcome...
April 2016: Metabolism: Clinical and Experimental
Luciana Concha L, Pilar Durruty A, Manuel García de Los Ríos A
Ketosis prone type 2 diabetes (KPD) is presently a well-defined clinical entity, characterized by a debut with severe hyperglycemia and ketoacidosis similar to the presenting form of Type 1 diabetes mellitus (DM1). However, it appears in subjects with Type 2 diabetes mellitus (DM2) phenotype. This situation is caused by an acute, reversible dysfunction of the beta cell in individuals with insulin resistance. Once the acute stage subsides, patients behave as having a DM2 and do not require insulin treatment...
September 2015: Revista Médica de Chile
Manna Zhang, Yan Li, Wenjie Cui, Peng Yang, Hong Li, Chunjun Sheng, Xiaoyun Cheng, Shen Qu
OBJECTIVE: To investigate the prevalence and clinical characteristics of ketosis-prone type 2 diabetes (KPD) in Chinese patients with young-onset diabetes. METHODS: A total of 238 young diabetic patients were recruited from our inpatient department from January 1, 2012, to December 28, 2014. KPD was defined as diabetes without precipitating illness and with the presence of ketosis or diabetic ketoacidosis in the absence of autoantibodies at the time of diagnosis...
December 2015: Endocrine Practice
S P Choukem, E Sobngwi, J P Garnier, S Letellier, F Mauvais-Jarvis, F Calvo, J-F Gautier
AIM: Previously, we described patients with ketosis-prone type 2 diabetes (KPD) and glucose-6-phosphate dehydrogenase (G6PD) deficiency, but no mutation of the G6PD gene. Our present study used two complementary approaches to test whether hyperglycaemia might inhibit G6PD activity: (1) effect of acute hyperglycaemia induced by glucose ramping; and (2) effect of chronic hyperglycaemia using correlation between G6PD activity and HbA1c levels. METHODS: In the first substudy, 16 KPD patients were compared with 11 healthy, non-diabetic control subjects of the same geographical background...
September 2015: Diabetes & Metabolism
Aidar R Gosmanov, Niyaz R Gosmanov
No abstract text is available yet for this article.
September 2015: Journal of Diabetes and its Complications
Xiaohao Wang, Huiwen Tan
The incidence of ketosis-prone diabetes mellitus (KPDM) shows a higher prevalence in men. The clear male predominance of this syndrome and its underlying pathogenesis mechanisms are unclear. KPDM, once described as atypical diabetes mellitus, idiopathetic type 1 diabetes (type 1B diabetes) and flatbush diabetes, is an uncommon form of diabetes characterized by severe reversible insulin deficiency. KPDM was first described and mostly observed in males of African-American descent and recently in Asian populations, including Japanese and Chinese...
July 2015: Biomedical Reports
Ruchi Gaba, Dhiraj Gambhire, Natalie Uy, Erica V Gonzalez, Dinakar Iyer, Christiane S Hampe, Nalini Ram, Ashok Balasubramanyam
OBJECTIVE: Unprovoked "A-β+" Ketosis-Prone Diabetes (KPD), a unique diabetic syndrome of adult-onset, obesity and proneness to ketoacidosis, is associated with rapid recovery of β cell function and insulin-independence. Whereas most patients experience prolonged remission, a subset relapses early to insulin dependence. We sought to define factors associated with early relapse. METHODS: We utilized a prospective, longitudinal database to analyze 50 unprovoked A-β+ KPD patients with >2 measurements of β cell function and glycemia following baseline assessment...
September 2015: Journal of Diabetes and its Complications
Eric V Balti, Marinette C Ngo-Nemb, Eric Lontchi-Yimagou, Barbara Atogho-Tiedeu, Valery S Effoe, Elvis A Akwo, Mesmin Y Dehayem, Jean-Claude Mbanya, Jean-François Gautier, Eugene Sobngwi
AIM: We investigated the association of HLA DRB1 and DQB1 alleles, haplotypes and genotypes with unprovoked antibody-negative ketosis-prone atypical diabetes (A(-) KPD) in comparison to type 2 diabetes (T2D). METHODS: A(-) KPD and T2D sub-Saharan African patients aged 19-63 years were consecutively recruited. Patients positive for cytoplasmic islet cell, insulin, glutamic acid decarboxylase or islet antigen-2 autoantibodies were excluded. Odds ratios were obtained via logistic regression after considering alleles with a minimum frequency of 5% in the study population...
January 2015: Diabetes Research and Clinical Practice
Justin L Rains, Sushil K Jain
BACKGROUND: Hyperketonemia is a pathological condition observed in patients with type 1 diabetes and ketosis-prone diabetes (KPD), which results in increased blood levels of acetoacetate (AA) and β-hydroxybutyrate (BHB). Frequent episodes of hyperketonemia are associated with a higher incidence of vascular disease. We examined the hypothesis that hyperketonemia activates the nuclear factor-κB (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways that regulate intercellular adhesion molecule 1 (ICAM-1) expression in endothelial cells...
March 2015: Metabolic Syndrome and related Disorders
P Gupta, Y Liu, M Lapointe, T Yotsapon, S Sarat, K Cianflone
AIMS: To evaluate circulating adipokines in people with ketosis-prone diabetes, a heterogeneous disorder characterized by unprovoked ketoacidosis in people with previously unrecognized diabetes. METHODS: Patients presenting with ketoacidosis with no previous diabetes diagnosis were compared with patients with previously established Type 1 diabetes. Baseline assessments of autoimmune status (A+/A-), and β-cell function (B+/B-), as well as leptin and adiponectin levels during a standardized mixed-meal tolerance test of 120 min, were performed...
May 2015: Diabetic Medicine: a Journal of the British Diabetic Association
Marcos M Lima-Martínez, Ernesto Guerra-Alcalá, Miguel Contreras, José Nastasi, Janelle A Noble, Constantin Polychronakos
UNLABELLED: Type 1 diabetes mellitus (T1DM) is a chronic disease characterized by the autoimmune destruction of pancreatic β-cells. This paper describes the case of a 19-year-old male patient who presented with glutamic acid decarboxylase (GAD) antibody positive and diabetic ketoacidosis, which mandated intensive insulin treatment. Once the ketoacidosis was controlled, an oral dose of 100 mg of sitagliptin was administered once a day. Ketoacidosis was managed by insulin and insulin daily requirement began to dwindle after one month, until its complete withdrawal at 8 weeks, when partial remission was reached...
2014: Endocrinology, Diabetes & Metabolism Case Reports
Yan Liu, Priyanka Gupta, Marc Lapointe, Thewjitcharoen Yotsapon, Sunthornyothin Sarat, Katherine Cianflone
BACKGROUND: Ketosis-prone diabetes (KPDM) is new-onset diabetic ketoacidosis without precipitating factors in non-type 1 diabetic patients; after management, some are withdrawn from exogenous insulin, although determining factors remain unclear. METHODS: Twenty KPDM patients and twelve type 1 diabetic patients (T1DM), evaluated at baseline, 12 and 24 months with/without insulin maintenance underwent a standardized mixed-meal tolerance test (MMTT) for 2 h. RESULTS: At baseline, triglyceride and C3 were higher during MMTT in KPDM vs...
2014: PloS One
A Radhakutty, J Shen, A J Hooper, S A Miller, J R Burnett, P M Mah, M G Burt, M P Doogue
AIMS: To determine if diabetic lipaemia is caused by loss of function mutations in the lipoprotein lipase gene, LPL. METHODS: We conducted a case-control study over 2 years in two tertiary care hospitals in South Australia. Six patients with a history of diabetic lipaemia and 12 control subjects, with previous diabetic ketoacidosis and peak triglyceride concentrations < 2.4 mmol/l were included. Participants were well at the time of study investigations. RESULTS: Only one patient with lipaemia had a loss of function mutation in LPL and no functional mutations in APOC2 or GPIHBP1 were identified...
December 2014: Diabetic Medicine: a Journal of the British Diabetic Association
T Yotsapon, S Sarat
INTRODUCTION: Diabetes presenting with ketoacidosis is a heterogeneous disorder. The purpose of this study was to determine whether ketosis-prone diabetes (KPDM) in Thai patients were different from type1 diabetes by assessment of the beta-cell response to a standardized mixed meal and pancreatic autoantibodies. MATERIAL AND METHODS: 20 patients who were categorized as ketosis-prone diabetes based on the occurrence of unprovoked DKA after the age of 30 years were compared with 12 type1 diabetic patients...
May 2014: Experimental and Clinical Endocrinology & Diabetes
Gelsey Goodstein, Anna Milanesi, Jane E Weinreb
No abstract text is available yet for this article.
April 2014: Diabetes Care
Shilpa Oak, Lakshmi K Gaur, Jared Radtke, Roshni Patel, Dinakar Iyer, Nalini Ram, Ruchi Gaba, Ashok Balasubramanyam, Christiane S Hampe
CONTEXT: Ketosis-prone diabetes (KPD), defined by presentation with diabetic ketoacidosis (DKA), comprises 4 subgroups based on the presence or absence of islet cell autoantibodies (A(-) or A(+)) and β-cell functional reserve (β(-) or β(+)). Among A(+) KPD, autoantibody epitope reactivity to 65-kDa glutamate decarboxylase (GAD65), defined by monoclonal GAD65Ab(DPD), was associated with greater β-cell functional reserve. In a majority of healthy individuals, GAD65Ab are present in the sera but are masked by anti-idiotypic antibodies; in contrast, overtly GAD65Ab-positive patients with autoimmune type 1 diabetes patients lack these anti-idiotypic antibodies...
June 2014: Journal of Clinical Endocrinology and Metabolism
Yun-Xia Zhou, Hui-Wen Tan, Ye-Rong Yu
OBJECTIVE: To evaluate the clinical features and epidemiological trend of diabetes ketosis (DK) in patients admitted to West China Hospital. METHODS: We reviewed medical records of diabetic patients with DK who were admitted to West China Hospital from 1997 to 2005. Their clinical and laboratory data were analysed with SAS 9.0. RESULTS: From 1997 to 2005, the proportion of diabetic patients with DK increased by 0.12% annually. The proportion of provoked DK patients (who had a clinically evident precipitating factor) in those with DK remained stable; whereas the proportion of T1D patients in those with DK declined by 2...
November 2013: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
M B Rabinowitz, H C Gonick, S R Levin, M B Davidson
Chromium (Cr) deficiency in experimental animals and in humans sustained by prolonged total parenteral nutrition has been shown to cause diabetes mellitus. Prior trials in humans indicated that Cr supplements, in either inorganic or organic form, may improve carbohydrate utilization. We report here a clinical double-blind, random cross-over trial of inorganic chromium trichloride, a brewer's yeast that contained Cr as glucose-tolerance-factor (GTF), a brewer's yeast extract without GTF, and a placebo. Forty-three outpatient diabetic men received three of these supplements for 4 months each...
December 1983: Biological Trace Element Research
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