Analysis and a long-term follow up of ketosis-onset Japanese NIDDM patients.
It has been reported that excessive intake of sugar-containing soft drinks results in diabetic ketoacidosis (DKA) or ketosis (DK) in obese patients with non-insulin dependent diabetes mellitus (NIDDM). We describe the clinical characteristics and results of long-term follow-up for 24 newly-diagnosed patients with acute-onset NIDDM presenting with DKA or DK. A history of excessive intake of sugar-containing soft drinks was found in 19 (Group A); serious non-diabetic illnesses were found in 5 (Group B). The range of patient ages in Group A was 16 to 57 years while all patients in Group B were 60 years or older. In Group A, no patient was positive for autoantibodies, specific HLAs for Japanese insulin dependent diabetes mellitus, or mutation of the beta-3-adrenergic receptor gene. The body mass indices (BMIs) at onset and admission and serum C-peptide immunoreactivities at admission and discharge were significantly higher in patients in Group A than in patients Group B. In conclusion, we reconfirmed that excessive intake of sugar-containing soft drinks is one of the contributing factors in DKA or DK-onset NIDDM patients. We found no autoimmune mechanism involved in the pathogenesis and that a polymorphism in the beta-3-adrenergic receptor gene could be associated with the development of soft-drink ketosis.
Department of Internal Medicine, Kitasato, University School of Medicine, Sagamihara, Kanagawa, Japan.
K
K
Tanaka
T
T
Moriya
A
A
Kanamori
Y
Y
Yajima
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000503:physiopathology* / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000209:etiology / Q000503:physiopathology*; D003927:Diet, Diabetic; D019422:Dietary Sucrose; D005260:Female; D005500:Follow-Up Studies; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D009765:Obesity; D013997:Time Factors
D019422:Dietary Sucrose; D006680:HLA Antigens; D007004:Hypoglycemic Agents; D007328:Insulin