Heterogeneity of early-onset and ketosis-resistant diabetes in Korean subjects--is it possible to determine cut-off age of early-onset type 2 diabetes?
OBJECTIVE
To investigate the heterogeneity of early-onset and ketosis-resistant diabetes and to define a not-arbitrary cut-off age for early-onset diabetes based on its clinical and metabolic characteristics, and diabetes complications.


METHODS
We classified 1015 early-onset diabetes subjects aged 21-40 into four groups (group I, age at diagnosis 21-25 years; group II, 26-30; group III, 31-35; group IV, 36-40). Familial and diabetic history, statue of insulin secretion, metabolic parameters, and diabetes complications were analyzed.


RESULTS
No significant difference in family history or the rate of diabetic complication was found in the four groups. Subjects with a 21 to a 25-year-old diabetes onset had the lowest serum C-peptide levels, with 50% of the cumulative 24-h urine C-peptide levels of the other three groups (p<0.0001). This group also had the lowest prevalence of hyperlipidemia and arterial hypertension (p<0.01 and <0.0001, respectively). Group III was found to have a higher prevalence of insulin insufficiency and hypertension than group IV.


CONCLUSIONS
Our data based on insulin secretory function and metabolic factors might suggest that a cut-off age of 26 years might be warranted in Korean patients. Korean early-onset type 2 diabetes patients tend to be non-obese and insulin secretory dysfunction.
Lee
Byung-Wan
BW
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Republic of Korea.
Kim
Sang-Yong
SY
Kim
Ji-Youn
JY
Cho
Kyun-Yung
KY
Chung
Yun-Jae
YJ
Min
Yong-Ki
YK
Chung
Jae-Hoon
JH
Lee
Moon-Kyu
MK
Lee
Myung-Shik
MS
Kim
Kwang-Won
KW
D000328:Adult; D017668:Age of Onset; D000419:Albuminuria / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000652:urine; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000145:classification* / Q000453:epidemiology* / Q000652:urine; D005260:Female; D005968:Glutamate Decarboxylase / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D001786:Blood Glucose; D002097:C-Reactive Protein; D002784:Cholesterol; D005968:Glutamate Decarboxylase; D006442:Glycated Hemoglobin