The first series of cases of ketosis-prone type 2 diabetes (flatbush diabetes) in Brazilian adults
SUMMARY Ketosis-prone type 2 diabetes (KPD) is an emerging form of diabetes mellitus characterized by unprovoked ketoacidosis, absence of autoimmunity and beta-cell dysfunction. The KPD may improve after initial glycemic compensation and evolve to exogenous insulin independence, most cases were obse...
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| Format: | Article |
| Language: | English |
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Brazilian Society of Endocrinology and Metabolism
2021-03-01
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| Series: | Archives of Endocrinology and Metabolism |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972021000200231&tlng=en |
| _version_ | 1819243675074428928 |
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| author | Luana Aparecida de Lima Ramaldes Sarah Simaan dos Santos João Roberto de Sa Patrícia Médici Dualib Sérgio Atala Dib |
| author_facet | Luana Aparecida de Lima Ramaldes Sarah Simaan dos Santos João Roberto de Sa Patrícia Médici Dualib Sérgio Atala Dib |
| author_sort | Luana Aparecida de Lima Ramaldes |
| collection | DOAJ |
| description | SUMMARY Ketosis-prone type 2 diabetes (KPD) is an emerging form of diabetes mellitus characterized by unprovoked ketoacidosis, absence of autoimmunity and beta-cell dysfunction. The KPD may improve after initial glycemic compensation and evolve to exogenous insulin independence, most cases were observed in populations with African or Hispanic backgrounds. We reviewed the literature on KPD and, to date, only one case of KPD has been described in Brazil's multi-ethnic population. A group of adult Brazilian KPD patients without autoimmunity and insulinopenia was identified for this study. We report a retrospective study of four KPD cases (3 males) evaluated in southeast Brazil, the patients were overweight or obese, age between the third and fifth decades of life, had a family history of type 2 diabetes, hyperglycemia (809.5 ± 344.2 mg/dL), acidosis (pH 7.21 ± 0.07; normal range (nr): 7.35-7.45 and bicarbonate 9.1 ± 6.2; nr: 22-26 mEq/mL), ketonuria (142.5 ± 114.4 mg/dL; nr: absence), absence of glutamic acid decarboxylase antibodies (GAD-65), and beta-cell function reserve (C-peptide 1.19 ± 0.53 ng/mL - nr: 1.1-4.4 ng/mL) on diagnosis. After glycemic compensation, there was increase of C-peptide (2.21 ± 0.41) indicating the recovery of beta-cell function and the time to insulin independence was 7.7 ± 3.5 months. They evolved after the period of glucotoxicity with insulin withdrawal and could be treated with oral antidiabetic therapy. This is the first case series of KPD described in Brazil being characterized by ketoacidosis at diagnosis, absence of autoimmunity, recovery of beta-cell function and insulin independence. |
| first_indexed | 2024-12-23T14:59:28Z |
| format | Article |
| id | doaj.art-408233d56c0c45aea835b07c228e5814 |
| institution | Directory Open Access Journal |
| issn | 2359-4292 |
| language | English |
| last_indexed | 2024-12-23T14:59:28Z |
| publishDate | 2021-03-01 |
| publisher | Brazilian Society of Endocrinology and Metabolism |
| record_format | Article |
| series | Archives of Endocrinology and Metabolism |
| spelling | doaj.art-408233d56c0c45aea835b07c228e58142022-12-21T17:42:40ZengBrazilian Society of Endocrinology and MetabolismArchives of Endocrinology and Metabolism2359-42922021-03-0165223123610.20945/2359-3997000000329The first series of cases of ketosis-prone type 2 diabetes (flatbush diabetes) in Brazilian adultsLuana Aparecida de Lima Ramaldeshttps://orcid.org/0000-0002-6196-7966Sarah Simaan dos Santoshttps://orcid.org/0000-0001-6550-5825João Roberto de Sahttps://orcid.org/0000-0003-3115-5606Patrícia Médici Dualibhttps://orcid.org/0000-0003-0358-1034Sérgio Atala Dibhttps://orcid.org/0000-0001-8653-8773SUMMARY Ketosis-prone type 2 diabetes (KPD) is an emerging form of diabetes mellitus characterized by unprovoked ketoacidosis, absence of autoimmunity and beta-cell dysfunction. The KPD may improve after initial glycemic compensation and evolve to exogenous insulin independence, most cases were observed in populations with African or Hispanic backgrounds. We reviewed the literature on KPD and, to date, only one case of KPD has been described in Brazil's multi-ethnic population. A group of adult Brazilian KPD patients without autoimmunity and insulinopenia was identified for this study. We report a retrospective study of four KPD cases (3 males) evaluated in southeast Brazil, the patients were overweight or obese, age between the third and fifth decades of life, had a family history of type 2 diabetes, hyperglycemia (809.5 ± 344.2 mg/dL), acidosis (pH 7.21 ± 0.07; normal range (nr): 7.35-7.45 and bicarbonate 9.1 ± 6.2; nr: 22-26 mEq/mL), ketonuria (142.5 ± 114.4 mg/dL; nr: absence), absence of glutamic acid decarboxylase antibodies (GAD-65), and beta-cell function reserve (C-peptide 1.19 ± 0.53 ng/mL - nr: 1.1-4.4 ng/mL) on diagnosis. After glycemic compensation, there was increase of C-peptide (2.21 ± 0.41) indicating the recovery of beta-cell function and the time to insulin independence was 7.7 ± 3.5 months. They evolved after the period of glucotoxicity with insulin withdrawal and could be treated with oral antidiabetic therapy. This is the first case series of KPD described in Brazil being characterized by ketoacidosis at diagnosis, absence of autoimmunity, recovery of beta-cell function and insulin independence.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972021000200231&tlng=en |
| spellingShingle | Luana Aparecida de Lima Ramaldes Sarah Simaan dos Santos João Roberto de Sa Patrícia Médici Dualib Sérgio Atala Dib The first series of cases of ketosis-prone type 2 diabetes (flatbush diabetes) in Brazilian adults Archives of Endocrinology and Metabolism |
| title | The first series of cases of ketosis-prone type 2 diabetes (flatbush diabetes) in Brazilian adults |
| title_full | The first series of cases of ketosis-prone type 2 diabetes (flatbush diabetes) in Brazilian adults |
| title_fullStr | The first series of cases of ketosis-prone type 2 diabetes (flatbush diabetes) in Brazilian adults |
| title_full_unstemmed | The first series of cases of ketosis-prone type 2 diabetes (flatbush diabetes) in Brazilian adults |
| title_short | The first series of cases of ketosis-prone type 2 diabetes (flatbush diabetes) in Brazilian adults |
| title_sort | first series of cases of ketosis prone type 2 diabetes flatbush diabetes in brazilian adults |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972021000200231&tlng=en |
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