title: Atypical diabetes in children: ketosis-prone type 2 diabetes.
abstract: Ketosis-prone type 2 diabetes mellitus also known as atypical or flatbush diabetes is being increasingly recognised worldwide. These patients are typically obese, middle-aged men with a strong family history of type 2 diabetes. The aetiology and pathophysiological mechanism is still unclear but some initial research suggests that patients with ketosis-prone type 2 diabetes have a unique predisposition to glucose desensitisation. These patients have negative autoantibodies typically associated with type 1 diabetes but have shown to have human leucocyte antigen (HLA) positivity. At initial presentation, there is an impairment of both insulin secretion and action. β Cell function and insulin sensitivity can be markedly improved by initiating aggressive diabetes management to allow for discontinuation of insulin therapy within a few months of treatment. These patients can be maintained on oral hypoglycaemic agents and insulin therapy can be safely discontinued after few months depending on their β cell function.
authors.affiliation: Department of Paediatrics, Bradford Royal Infirmary, Bradford, West Yorkshire, UK. atulvaibhav@hotmail.com
authors.forename: Atul
authors.initials: A
authors.lastname: Vaibhav
authors.forename: Mathew
authors.initials: M
authors.lastname: Mathai
authors.forename: Shaun
authors.initials: S
authors.lastname: Gorman
mesh_terms: D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000145:classification / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000209:etiology*; D006801:Humans; D008297:Male