title: Type 2 diabetes presenting as diabetic ketoacidosis in adolescence.
abstract: We report two black adolescent subjects who presented with diabetic ketoacidosis, but who lacked autoimmune markers and demonstrated clinical and biochemical characteristics more typical of Type 2 diabetes, including obesity, acanthosis nigricans, positive family history for Type 2 diabetes, and Type 2 diabetic dyslipidaemia. Subsequent to acute presentation, insulin was discontinued in both subjects and excellent glycaemic control was achieved with metformin therapy alone. Four months following acute presentation, both had adequate C-peptide responses to intravenous glucagon. Type 2 diabetes can present as diabetic ketoacidosis in obese adolescent subjects.
authors.affiliation: Department of Endocrinology and Metabolic Medicine, St Mary's Hospital, London, UK. j.valabhji@ic.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Valabhji
authors.forename: M
authors.initials: M
authors.lastname: Watson
authors.forename: J
authors.initials: J
authors.lastname: Cox
authors.forename: C
authors.initials: C
authors.lastname: Poulter
authors.forename: C
authors.initials: C
authors.lastname: Elwig
authors.forename: R S
authors.initials: RS
authors.lastname: Elkeles
mesh_terms: D000052:Acanthosis Nigricans / Q000150:complications*; D000293:Adolescent; D001786:Blood Glucose; D001835:Body Weight; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007333:Insulin Resistance; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D009765:Obesity / Q000209:etiology
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin