Journal List > Korean Diabetes J > v.32(5) > 1002247

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Jang, Yi, Lee, Chun, Baek, Song, Yoo, Lee, Yoon, Kang, Lee, and Kim: The Classification of Diabetic Patients Presenting Diabetic Ketoacidosis: The Characteristics of Fulminant Type 1 Diabetes
Original Article
Korean Diabetes Journal

Korean Diabetes Journal 2008; 32(5): 428-434.

Published online: 31 October 2008

DOI: https://doi.org/10.4093/kdj.2008.32.5.428

The Classification of Diabetic Patients Presenting Diabetic Ketoacidosis: The Characteristics of Fulminant Type 1 Diabetes

Eun-hee Jang, Jeong-Eun Yi, Seung-Jae Lee, Sang-Hoon Chun, Ki-Hyun Baek, Ki-Ho Song, Soon-Jib Yoo, Jong-Min Lee, Kun-Ho Yoon, Moo-Il Kang, Kwang-Woo Lee, Mee-Kyung Kim

Department of Internal Medicine, The Catholic University of Korea, Korea.

Corresponding author: euneejang@gmail.com

Received 4 June 2008       Accepted 18 August 2008

Copyright © 2008 Korean Diabetes Association

Abstract

Background

The aim of the study was to classify newly diagnosed diabetic patients who initially presented with diabetic ketoacidosis (DKA) into specific types of diabetes and to describe the clinical and biochemical characteristics of patients with fulminant type 1 DM in Korea.

Methods

Using data from 4 hospitals of CMC from 1 January 1999 to 1 March 2008, we identified all patients who manifested DKA when they were first diagnosed as diabetes. Clinical and laboratory data were reviewed from medical records.

Results

We identified 51 newly diagnosed diabetic patients manifested DKA. Among them, 14 (27.4%) patients were classified as autoimmune type 1 DM, 8 (15.7%) as antibody negative type 1 DM, 5 (9.8%) as fulminant type 1, 16 (31.4%) as type 2 DM and 8 (15.7%) as secondary DM. Five patients who fulfilled the criteria of fulminant type 1 DM were older (32.2 ± 10.7 vs. 15.7 ± 4.4 years, P = 0.010), had shorter duration of symptoms (4.2 ± 2.7 vs.16.7 ± 15.2 days, P = 0.014) and lower stimulated C-peptide levels (0.1 ± 0.0 vs. 0.7 ± 0.6 ng/mL, P = 0.050) compared with patients with autoimmune type 1 DM.

Conclusion

Newly diagnosed diabetic patients presenting with DKA composed of heterogenous types of diabetes. The prevalence of fulminant type 1 diabetes among them was 9.8% and the clinical and biochemical characteristics of these patients were different from those of autoimmune type 1 DM.

Keywords: Diabetic ketoacidosis, Fulminant type 1 DM, Korea

Figures and Tables

Table 1
Clinical characteristics of fulminant type1 diabetes compared with that of autoimmune type 1 diabetes or type 2 diabetes
kdj-32-428-i001

BMI, body mass index; KPD, ketosis-prone diabetes.

Table 2
Laboratory findings of fulminant type 1 diabetes compared with that of autoimmune type 1 diabetes or type 2 diabetes
kdj-32-428-i002

AST, aspartate aminotransferase; ALT, alanine aminotransferase.

Table 3
Characteristics of individual patients with fulminant type 1 daibetes
kdj-32-428-i003

*pregnancy associated fulminant type 1 diabetes.

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