Clinical courses and changes of pancreatic beta-cell function in young-onset diabetics: report of two cases.
Accurate classification of diabetes in some young patients is difficult but clearly of importance in deciding the appropriate treatment. We report the different clinical courses and beta-cell function changes in 2 young-onset diabetics. In the beginning, each of them was considered to be a patient with insulin-dependent diabetes mellitus (IDDM) and was treated with insulin. Then, treatment was shifted from insulin to oral hypoglycemic agents (OHA) because each patient's beta-cell function was comparable to that of patients with non-insulin-dependent diabetes mellitus (NIDDM). In case 1, the patient's glycemic control and beta-cell function progressively deteriorated and finally insulin therapy was required. In case 2, the patient was continuously treated with OHA. Although his blood glucose was not well-controlled, his beta-cell function had been well-preserved. Recently he achieved near-normoglycemia by improving his diet and OHA compliance. Clearly, case 1 was a slowly progressive Type 1 DM patient and case 2 was a young Type 2 DM patient. This classification was further supported by the finding that the patient in case 1 had human leukocyte antigen (HLA)-DR3, but the patient in case 2 did not.
Hwang
J S
JS
Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Juang
J H
JH
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D015803:HLA-DR3 Antigen / Q000032:analysis; D006801:Humans; D007515:Islets of Langerhans / Q000503:physiopathology*; D008297:Male
D015803:HLA-DR3 Antigen