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Ketosis prone diabetes

Priyathama Vellanki, Guillermo E Umpierrez
OBJECTIVE: More than half of African Americans (AA) with a new diagnosis of diabetic ketoacidosis have clinical and metabolic features of type 2 diabetes during follow-up. This particular presentation of diabetes has been termed as ketosis-prone type 2 diabetes (KPDM) or atypical diabetes. METHODS: We review the epidemiology, diagnosis, pathophysiology and acute and long-term management of AA with KPDM and compare these similarities to patients with type 2 diabetes...
May 23, 2017: Endocrine Practice
Cliona Small, Aoife M Egan, El Muntasir Elhadi, Michael W O'Reilly, Aine Cunningham, Francis M Finucane
SUMMARY: We describe three patients presenting with diabetic ketoacidosis secondary to ketosis prone type 2, rather than type 1 diabetes. All patients were treated according to a standard DKA protocol, but were subsequently able to come off insulin therapy while maintaining good glycaemic control. Ketosis-prone type 2 diabetes (KPD) presenting with DKA has not been described previously in Irish patients. The absence of islet autoimmunity and evidence of endogenous beta cell function after resolution of DKA are well-established markers of KPD, but are not readily available in the acute setting...
2017: Endocrinology, Diabetes & Metabolism Case Reports
Jun Tang, Chen-Yi Tang, Fang Wang, Yue Guo, Hao-Neng Tang, Ci-La Zhou, Shu-Wen Tan, Shi-Ping Liu, Zhi-Guang Zhou, Hou-De Zhou
BACKGROUND: To analyze the gene mutation and mental disorder of a Chinese ketosis-prone diabetes (KPD) family, and to make a precise diagnosis and give a treatment for them. METHODS: We studied a Chinese family with a clinical diagnosis of maturity-onset diabetes of the young (MODY). The clinical data and the blood samples were collected. The promotor and coding regions inclusive intron exon boundaries of the HNF1A, HNF4A were detected by polymerase chain reaction (PCR) and direct sequencing...
2017: Diabetology & Metabolic Syndrome
Keizo Kaneko, Chihiro Satake, Junpei Yamamoto, Hironori Takahashi, Shojiro Sawada, Junta Imai, Tetsuya Yamada, Hideki Katagiri
Fulminant type 1 diabetes is characterized by remarkably rapid and complete β-cell destruction. The established diagnostic criteria include the occurrence of diabetic ketosis soon after the onset of hyperglycemic symptoms, elevated plasma glucose with relatively low HbA1c at the first visit, and extremely low C-peptide. Serum C-peptide levels remain extremely low over a prolonged period. A 26-year-old-man with diabetic ketosis was admitted to our hospital. His relatively low HbA1c (7.6%), despite marked hyperglycemia (593 mg/dL) with marked ketosis, indicated abrupt onset...
March 31, 2017: Endocrine Journal
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...
January 2017: 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...
February 2017: 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
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