Young Chinese adults with new onset of diabetic ketoacidosis--clinical course, autoimmune status and progression of pancreatic beta-cell function.
OBJECTIVE
To examine the clinical course, autoimmune status and pancreatic beta cell function, over a 2-year period, in young Chinese subjects newly presenting with diabetic ketoacidosis (DKA).


METHODS
A prospective study involving 562 out of 27,893 patients who were admitted to the medical ward with a principal diagnosis of diabetes mellitus during the recruitment period of 1 year.


RESULTS
Of these 562 patients, 27 were aged less than 35 years and admitted with a diagnosis of DKA and 11 (six males and five females) of these were newly diagnosed. Antibodies to glutamic acid decarboxylase (GAD) were present in five patients. Anti-ICA 512 was not detected in any of the patients. Basal and post-glucagon stimulated plasma C-peptide remained in the insulin-deficient range although showing improvement at 2 years.


CONCLUSIONS
These findings confirm the relative rarity of autoimmune Type 1 diabetes in young Chinese. Even when the clinical presentation takes the extreme form of acute DKA, less than 50% have positive autoimmune markers.
Li
J K
JK
Department of Medicine, Yan Chai Hospital, Hong Kong.
Chan
J C
JC
Zimmet
P Z
PZ
Rowley
M J
MJ
Mackay
I R
IR
Cockram
C S
CS
D000328:Adult; D044466:Asian People; D001323:Autoantibodies / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood*; D002681:China / Q000208:ethnology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005934:Glucagon; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006723:Hong Kong; D006801:Humans; D007515:Islets of Langerhans / Q000378:metabolism*; D008297:Male
D001323:Autoantibodies; D001786:Blood Glucose; D002096:C-Peptide; D005934:Glucagon; D005968:Glutamate Decarboxylase