title: Clinical characteristics and insulin independence of Koreans with new-onset type 2 diabetes presenting with diabetic ketoacidosis.
abstract: BACKGROUND
  We evaluated the incidence, characteristics and insulin independence of Koreans with new-onset type 2 diabetes (T2D) initially presenting with diabetic ketoacidosis (DKA).
  
  
  METHODS
  We analysed clinical and biochemical data from diabetic patients presenting with DKA. They were classified into ketosis-prone diabetes (KPD) type 1A (KPD-T1A) (A+β-), type 1B (KPD-T1B) (A-β-), type 2A (KPD-T2A) (A+β+) or type 2B (KPD-T2B) (A-β+) according to the presence or absence of an autoantibody and β-cell reserve. Changes in therapy after insulin discontinuation were evaluated for up to 4 years. We also compared clinical and biochemical characteristics between newly diagnosed T2D patients presenting with DKA and previously diagnosed T2D patients presenting with DKA.
  
  
  RESULTS
  Among 60 newly diagnosed KPD patients, 18, 21 and 21 patients were classified as KPD-T1A, KPD-T1B and KPD-T2B, respectively. In the KPD-T2B group, both fasting and stimulated C-peptide were recovered over 6 months. After 4 years of DKA development, 75% of KPD-T2B subjects no longer required insulin. Compared with previously diagnosed T2D patients presenting with DKA, newly diagnosed KPD-T2B patients tended to be younger, more obese and showed better insulin secretory function after recovery from DKA.
  
  
  CONCLUSIONS
  New-onset T2D patients presenting with DKA was not uncommon among the Korean population. In contrast to previously diagnosed T2D patients presenting with DKA, who showed a progressive decrease in insulin secretory function, new-onset KPD-T2B patients recovered insulin secretory function over time, and insulin independence could be expected.
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors: H
authors: H
authors: Seok
authors: C H
authors: CH
authors: Jung
authors: S W
authors: SW
authors: Kim
authors: M J
authors: MJ
authors: Lee
authors: W J
authors: WJ
authors: Lee
authors: J H
authors: JH
authors: Kim
authors: B-W
authors: BW
authors: Lee
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D016883:Diabetic Ketoacidosis / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D028761:Withholding Treatment / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D007328:Insulin
keywords: diabetes mellitus; insulin secretion; ketoacidosis