ORIGINAL ARTICLE   

Minerva Endocrinologica 2019 December;44(4):351-6

DOI: 10.23736/S0391-1977.18.02925-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Heterogeneous clinical features of ketosis-prone type 2 diabetes mellitus patients: gender, age, loss of weight and HbA1c

Juan WANG, Meixiang ZHANG, Zhenzhen LIU, Xiujie WANG, Yuanxin PANG, Ye LU, Zhengqing LIU ✉

Unit of Endocrinology, Department of Rheumatism, the First People’s Hospital of Wujiang District Suzhou, Suzhou, China

BACKGROUND: The aim of this study was to observe the clinical features of type 2 diabetes mellitus (T2DM) patients with ketosis as the initial symptom, and investigate its differences from clinical features of non-ketotic T2DM patients.
METHODS: A total of 385 T2DM patients treated in our hospital from 2014 to 2017 were selected and divided into ketosis-prone T2DM group and non-ketotic T2DM group. Ketosis-prone T2DM patients refer to DM patients with the urine ketone body++ or above or the blood ketone body ≥1.0 mmol/L when treated. Fasting venous blood was collected from all patients in the early morning at 2 d after admission to detect the liver function, renal function, blood glucose, triglyceride, total cholesterol, glycosylated hemoglobin and fasting C-peptide, glutamic acid decarboxylase antibody (GAD-Ab) and islet cell antibody (ICA) were also detected, and the 24 h urine specimen was retained to detect the 24 h urine microalbumin excretion rate.
RESULTS: The proportion of male in ketosis-prone T2DM group was significantly higher than that in non-ketotic T2DM group (P<0.01). Patients in ketosis-prone T2DM group was younger than those in non-ketotic T2DM group (P<0.05). The number of days from initial symptom to treatment in ketosis-prone T2DM group was smaller than that in non-ketotic T2DM group (P<0.05). The fasting C-peptide level in ketosis-prone T2DM group was significantly lower than that in non-ketotic T2DM group (P<0.05). The degree of weight loss and level of glycosylated hemoglobin in ketosis-prone T2DM group were significantly higher than those in non-ketotic T2DM group (P<0.05).
CONCLUSIONS: Ketosis-prone T2DM patients are characterized by lower age at onset, higher proportion of male, shorter duration of disease, poorer islet function, higher blood glucose and more significant weight loss than non-ketotic T2DM patients.

KEY WORDS: Diabetes mellitus, type 2; Glycated hemoglobin A; Ketosis