AI Article Synopsis
- - Ketosis-prone diabetes (KPDM) occurs when non-type 1 diabetes patients experience diabetic ketoacidosis without known triggers; some can stop insulin treatment after management, but reasons for this are still being studied.
- - In a study comparing 20 KPDM patients to 12 type 1 diabetics (T1DM), KPDM patients showed higher triglycerides and C3 levels at baseline, but those who stopped insulin had lower non-esterified fatty acids (NEFA) than those who continued insulin treatment.
- - The findings indicate that even though KPDM-ins patients had more body fat, they exhibited better insulin sensitivity, illustrated by decreased NEFA levels and different profiles of Acylation Stimulating Protein (ASP)
Article Abstract
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diabetic ketoacidosis without precipitating factors in non-type 1 diabetic patients; after management, some are withdrawn from exogenous insulin, although determining factors remain unclear.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. T1DM (p<0.0001) with no differences in non-esterified fatty acids (NEFA) while Acylation Stimulating Protein (ASP) tended to be higher. Within 12 months, 11 KPDM were withdrawn from insulin treatment (KPDM-ins), while 9 were maintained (KPDM+ins). NEFA was lower in KPDM-ins vs. KPDM+ins at baseline (p = 0.0006), 12 months (p<0.0001) and 24 months (p<0.0001) during MMTT. NEFA in KPDM-ins decreased over 30-120 minutes (p<0.05), but not in KPDM+ins. Overall, C3 was higher in KPDM-ins vs KPDM+ins at 12 months (p = 0.0081) and 24 months (p = 0.0019), while ASP was lower at baseline (p = 0.0024) and 12 months (p = 0.0281), with a decrease in ASP/C3 ratio.
Conclusions: Notwithstanding greater adiposity in KPDM-ins, greater NEFA decreases and lower ASP levels during MMTT suggest better insulin and ASP sensitivity in these patients.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4183552 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0109237 | PLOS |
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