Ketosis-prone atypical diabetes in Cameroonian people with hyperglycaemic crisis: frequency, clinical and metabolic phenotypes

Autor: Eric Lontchi-Yimagou, Jean-François Gautier, Jean Claude Mbanya, Jean Jacques Noubiap, Philippe Boudou, Barbara Atogho-Tiedeu, Felix Assah, Eugene Sobngwi, J.-L. Nguewa, E. Djahmeni, Eric V. Balti
Přispěvatelé: Pathology/molecular and cellular medicine, Faculty of Medicine and Pharmacy, Diabetes Pathology & Therapy
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
Diabetic ketoacidosis
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Population
030209 endocrinology & metabolism
Diabetic Ketoacidosis
Diagnosis
Differential
03 medical and health sciences
Hospitals
Urban
0302 clinical medicine
Endocrinology
Insulin resistance
Insulin-Secreting Cells
Diabetes mellitus
Internal medicine
Insulin Secretion
Internal Medicine
medicine
Humans
Insulin
Cameroon
030212 general & internal medicine
education
Referral and Consultation
Aged
Glycated Hemoglobin
education.field_of_study
medicine.diagnostic_test
business.industry
Middle Aged
medicine.disease
Combined Modality Therapy
Cross-Sectional Studies
Diabetes Mellitus
Type 2
Hyperglycemia
Acute Disease
Female
Insulin Resistance
Ketosis
business
Lipid profile
Ketosis-prone diabetes
Zdroj: Diabetic Medicine. 34:426-431
ISSN: 0742-3071
Popis: Aim It is unclear whether ketosis-prone diabetes is a specific type or a subtype of Type 2 diabetes. We aimed to describe the clinical and metabolic features of ketosis-prone diabetes in a sub-Saharan population. Methods We consecutively enrolled and characterized 173 people with non-autoimmune diabetes admitted for hyperglycaemic crisis at the Yaounde Central Hospital, Cameroon. Blood samples were collected for fasting glucose, HbA1c, lipid profile and C-peptide assays with insulin resistance and secretion estimation by homeostasis model assessment. People were classified as having Type 2 diabetes (n = 124) or ketosis-prone diabetes (n = 49). Ketosis-prone diabetes was sub-classified as new-onset ketotic phase (n = 34) or non-ketotic phase (n = 15). Results Ketosis-prone diabetes was found in 28.3% of the hyperglycaemic crises. Age at diabetes diagnosis was comparable in Type 2 and ketosis-prone diabetes [48 ± 14 vs 47 ± 11 years; P = 0.13] with a similar sex distribution. Overall BMI was 27.7 ± 13.4 kg/m2 and was ≥ 25 kg/m2 in 55.8% of those taking part, however, 73.5% of those with ketosis-prone diabetes reported weight loss of > 5% at diagnosisBlood pressure and lipid profile were comparable in both types. Ketosis-prone diabetes in the ketotic phase was characterized by lower insulin secretion and higher serum triglycerides compared with non-ketotic ketosis prone and Type 2 diabetes. Type 2 and ketosis prone diabetes in the non-ketotic phase were comparable in terms of lipid profile, blood pressure, waist-to-hip ratio, BMI and fat mass, insulin secretion and insulin resistance indices. Conclusions Ketosis-prone diabetes is likely to be a subtype of Type 2 diabetes with the potential to develop acute insulinopenic episodes. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
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