Frequency of insulin-dependent diabetes mellitus in Turkish adult-onset diabetic population.
The frequency of insulin-dependent diabetes mellitus in the Turkish adult-onset diabetic population has not been assessed previously. In the present study, we retrospectively evaluated the medical records of 801 Turkish patients with adult-onset (> or = 30 years) diabetes to determine the frequency of cases diagnosed as insulin-dependent diabetes. Fifty-two (6.5%) patients met our criteria of adult-onset insulin-dependent diabetes mellitus. At disease onset, 20 patients presented with ketoacidosis (38.5%), while 32 patients (61.5%) were non-ketotic. In the insulin-dependent diabetic group, islet cell antibodies were positive in 10 out of 16 (62.5%) patients studied. In contrast, none of the 16 patients had positive reactions with respect to insulin autoantibodies. Twelve out of 20 patients (60%) had glucagon-stimulated C-peptide levels above 0.6 nmol/l, suggesting a sufficient insulin secretory reserve. In view of these observations, we conclude that insulin-dependent diabetes mellitus is not rare among patients with adult-onset diabetes in the Turkish population. In a majority of cases, the disease onset is non-ketotic. Beta-cell function is relatively preserved, and insulin autoantibodies do not develop at diagnosis. In contrast, islet cell antibodies are frequently present at the onset of clinical insulin-dependent diabetes, possibly indicating continuing beta-cell destruction.
Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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Gürlek
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Erbaş
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Sayinalp
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Gedik
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D002096:C-Peptide / Q000097:blood / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D016883:Diabetic Ketoacidosis / Q000453:epidemiology; D005260:Female; D005934:Glucagon; D006801:Humans; D015994:Incidence; D007330:Insulin Antibodies / Q000097:blood; D007515:Islets of Langerhans / Q000276:immunology / Q000378:metabolism; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D014421:Turkey / Q000453:epidemiology
D001323:Autoantibodies; D001786:Blood Glucose; D002096:C-Peptide; D007330:Insulin Antibodies; C024211:islet cell antibody; D005934:Glucagon