We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Fulminant Type 1 Diabetes in Korea: High Prevalence Among Patients with Adult-Onset Type 1 Diabetes.
- Authors
Kim, Jin Taek; Koo, Bo Kyung; Yang, Sei Won; Shin, Dong Hoon; Yu, Sung Hoon; Choi, Sung Hee; Lim, Soo; Moon, Min Kyong; Kim, Jae Hyun; Cho, Young Min; Park, Kyong Soo; Jang, Hak Chul; Lee, Hong Kyu
- Abstract
Fulminant type 1 diabetes is a recently defined subtype of idiopathic (type 1B) diabetes characterized by rapid progression to diabetic ketoacidosis with rapid beta cell destruction, resultant low HbA1c at diagnosis and absence or scarcity of known islet autoantibodies. We investigated the prevalence and clinical characteristics of fulminant type 1 diabetes among Korean patients newly diagnosed with type 1 diabetes. By using the data retrieved from the Seoul National University Hospital database, we identified all patients newly diagnosed with type 1 diabetes from January 1999 through July 2006. Information on clinical manifestations and laboratory data, including the presence of islet autoantibodies detected at diagnosis were obtained by reviewing medical records. Fulminant type I diabetes was defined according to the criteria Imagawa et al. used. 1) Occurrence of ketosis or ketoacidosis soon after (around 7 days) the hyperglycemic symptoms, 2) urinary C-peptide excretion < 10 µg/day, fasting C-peptide < 0.3 ng/mL, or serum C-peptide < 0.5 ng/mL after glucagon injection or glucose loading and 3) HbA1c < 8.5% on the first visit. We identified 99 patients newly diagnosed with type I diabetes of which 7 (7.1%) fulfilled the criteria of fulminant type 1 diabetes. Of these 7, none were positive for islet autoantibodies. Among the patients with onset age ≥ 18 years, the percentage of fulminant type 1 diabetes reached at 30.4%. The onset age of patients with fulminant type 1 diabetes was higher than that of patients with non-fulminant type 1 diabetes (P < 0.001). Patients with fulminant type 1 diabetes showed a markedly shorter duration from the onset of hyperglycemic symptoms to the first hospital visit (P < 0.001), increased serum aspartate aminotransferase or amylase levels (P < 0.05), and decreased glucagon-stimulated serum C-peptide response (P < 0.05). None of fulminant type I diabetes patients had honeymoon periods through 1 year follow up after diagnosis of type 1 diabetes. In conclusion, fulminant type 1 diabetes was prevalent in 7.1% of all patients newly diagnosed with type I diabetes and in 30.4% of patients with adult-onset diabetes in Korea. The clinical and metabolic characteristics were similar to those reported in Japanese studies.
- Subjects
KOREA; DIABETES; PEOPLE with diabetes; KETOACIDOSIS; PANCREATIC beta cells; AUTOANTIBODIES; C-peptide; GLUCAGON
- Publication
Diabetes, 2007, Vol 56, pA254
- ISSN
0012-1797
- Publication type
Article