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Should diabetic ketosis without acidosis be included in ketosis‐prone type 2 diabetes mellitus?
Author(s) -
Xie XiaoJing,
Hu Yun,
Cheng Cheng,
Feng TianTian,
He Ke,
Mao XiaoMing
Publication year - 2014
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2448
Subject(s) - medicine , ketosis , diabetes mellitus , diabetic ketoacidosis , acidosis , population , type 2 diabetes , endocrinology , type 2 diabetes mellitus , type 1 diabetes , body mass index , incidence (geometry) , ketoacidosis , environmental health , physics , optics
Background The incidence of ketosis‐prone type 2 diabetes is very low except for people of sub‐Saharan African origin and African Americans. However, there also are some type 2 diabetes patients with diabetic ketosis without acidosis (DKWA). We question whether DKWA should be included as a subtype of ketosis‐prone type 2 diabetes mellitus and compared the clinical characteristics of DKWA and diabetic ketoacidosis (DKA) patients. Methods The study population consisted of 594 consecutive unrelated Chinese inpatients with newly diagnosed type 2 diabetes. Demographic and clinical characteristics (age, gender, family history of diabetes, body mass index, blood pressure and plasma lipid parameters) were recorded. The patients were divided into ketosis‐resistant diabetes (KRD), DKWA and DKA groups on the basis of urinary ketones, blood pH and bicarbonate levels. The blood glucose and c‐peptide levels of the patients were also evaluated. Results The prevalence of KRD, DKWA and DKA were 78.33%, 19.72% and 1.95%, respectively, in the study population. The clinical characteristics of patients with DKWA group patients were similar to those with DKA, except that DKA patients had higher blood glucose and deteriorated β cell function. Conclusions Diabetic ketosis without acidosis and DKA patients share similar clinical characteristics; DKWA should be considered ketosis‐prone type 2 diabetes. Therefore, the prevalence of ketosis‐prone type 2 diabetes might be underestimated. Copyright © 2013 John Wiley & Sons, Ltd.