title: Clinical courses and changes of pancreatic beta-cell function in young-onset diabetics: report of two cases.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
authors.forename: J S
authors.initials: JS
authors.lastname: Hwang
authors.forename: J H
authors.initials: JH
authors.lastname: Juang
mesh_terms: 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
chemical_list: D015803:HLA-DR3 Antigen