title: Markedly increased serum and urinary fructose concentrations in diabetic patients with ketoacidosis or ketosis.
abstract: To investigate fructose concentrations in diabetic patients with ketoacidosis or ketosis, serum fructose concentrations and daily urinary fructose excretion were measured in 23 patients with ketoacidosis (n = 16) and ketosis (n = 7) on the first day of admission. Seventeen patients were diagnosed with type 1, one patient with mitochondrial, and 4 patients with atypical diabetes. In 16 of the 23 patients, serum and urinary fructose could be assessed after starting treatments. Mean serum fructose concentration was 71.6 ± 108.1 μmol/l, and mean daily urinary fructose excretion was 352.1 ± 473.7 μmol/day. Serum fructose levels in patients with atypical diabetes were much higher (205.0 ± 213.3 μmol/l) than those in patients with type 1 diabetes (45.1 ± 44.5 μmol/l), while urinary fructose levels in atypical diabetes (249.7 ± 92.4 μmol/day) tended to be lower than those in type 1 diabetes (382.6 ± 533.2 μmol/day). Serum fructose concentrations decreased significantly (P < 0.05) from 88.1 ± 126.3 to 18.0 ± 11.0 μmol/l, and daily urinary fructose excretion also decreased significantly (P < 0.05) from 459.8 ± 530.9 to 75.1 ± 62.0 μmol/day in accordance with glycemic normalization after treatment. Marked and reversible increases in serum and urinary fructose concentrations were observed in diabetics with ketoacidosis and ketosis.
authors.affiliation: Department of Internal Medicine, Teikyo University, School of Medicine, Kaga, Itabashi, Tokyo, Japan. t-kawa@med.teikyo-u.ac.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kawasaki
authors.forename: Kanji
authors.initials: K
authors.lastname: Igarashi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ogata
authors.forename: Yoko
authors.initials: Y
authors.lastname: Oka
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ichiyanagi
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yamanouchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000097:blood* / Q000652:urine*; D005260:Female; D005632:Fructose / Q000097:blood* / Q000652:urine*; D006801:Humans; D007662:Ketosis / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D005632:Fructose