당뇨병성 케톤산증 발생으로 당뇨병이 처음 진단된 환자의 병형 분류: 전격성 제1형 당뇨병의 임상적 특징 The Classification of Diabetic Patients Presenting Diabetic Ketoacidosis: The Characteristics of Fulminant Type 1 Diabetes
당뇨병성 케톤산증으로 당뇨병을 처음 진단 받은 환자에서 베타세포의 자가면역성과 베타세포의 인슐린분비능에 따라서 당뇨병형을 구분해 보았을 때 자가면역성 제1형 당뇨병은 27.4%, 자가항체 음성 제 1형 당뇨병 15.7%, 전격성 제1형 당뇨병 9.8%, 제2형 당뇨병 31.4% 그리고 이차성 당뇨병 15.7%로 다양하게 분포함을 확인할 수 있었다. 이 중 전격성 제1형 당뇨병은 제2형 당뇨병환자와 유사한 나이에 생겼으며 주로 구토나 복통과 같은 소화기 증상을 주소로 응급실을 방문하였고 검사실 검사로는 베타세포의 인슐린 분비능이 매우 떨어져 있는 특징을 가지고 있었다.
당뇨병성 케톤산증으로 당뇨병을 처음 진단 받은 환자에서 베타세포의 자가면역성과 베타세포의 인슐린분비능에 따라서 당뇨병형을 구분해 보았을 때 자가면역성 제1형 당뇨병은 27.4%, 자가항체 음성 제 1형 당뇨병 15.7%, 전격성 제1형 당뇨병 9.8%, 제2형 당뇨병 31.4% 그리고 이차성 당뇨병 15.7%로 다양하게 분포함을 확인할 수 있었다. 이 중 전격성 제1형 당뇨병은 제2형 당뇨병환자와 유사한 나이에 생겼으며 주로 구토나 복통과 같은 소화기 증상을 주소로 응급실을 방문하였고 검사실 검사로는 베타세포의 인슐린 분비능이 매우 떨어져 있는 특징을 가지고 있었다.
Background: The aim of the study was to classify newly diagnosed diabetic patients who initially presented with diabetic ketoacidosis (DKA) into specific types of diabetes and to describe the clinical and biochemical characteristics of patients with fulminant type 1 DM in Korea. Methods: Using data ...
Background: The aim of the study was to classify newly diagnosed diabetic patients who initially presented with diabetic ketoacidosis (DKA) into specific types of diabetes and to describe the clinical and biochemical characteristics of patients with fulminant type 1 DM in Korea. Methods: Using data from 4 hospitals of CMC from 1 January 1999 to 1 March 2008, we identified all patients who manifested DKA when they were first diagnosed as diabetes. Clinical and laboratory data were reviewed from medical records. Results: We identified 51 newly diagnosed diabetic patients manifested DKA. Among them, 14 (27.4%) patients were classified as autoimmune type 1 DM, 8 (15.7%) as antibody negative type 1 DM, 5 (9.8%) as fulminant type 1, 16 (31.4%) as type 2 DM and 8 (15.7%) as secondary DM. Five patients who fulfilled the criteria of fulminant type 1 DM were older (32.2 ± 10.7 vs. 15.7 ± 4.4 years, P = 0.010), had shorter duration of symptoms (4.2 ± 2.7 vs.16.7 ± 15.2 days, P = 0.014) and lower stimulated C-peptide levels (0.1 ± 0.0 vs. 0.7 ± 0.6 ng/mL, P = 0.050) compared with patients with autoimmune type 1 DM. Conclusion: Newly diagnosed diabetic patients presenting with DKA composed of heterogenous types of diabetes. The prevalence of fulminant type 1 diabetes among them was 9.8% and the clinical and biochemical characteristics of these patients were different from those of autoimmune type 1 DM.
Background: The aim of the study was to classify newly diagnosed diabetic patients who initially presented with diabetic ketoacidosis (DKA) into specific types of diabetes and to describe the clinical and biochemical characteristics of patients with fulminant type 1 DM in Korea. Methods: Using data from 4 hospitals of CMC from 1 January 1999 to 1 March 2008, we identified all patients who manifested DKA when they were first diagnosed as diabetes. Clinical and laboratory data were reviewed from medical records. Results: We identified 51 newly diagnosed diabetic patients manifested DKA. Among them, 14 (27.4%) patients were classified as autoimmune type 1 DM, 8 (15.7%) as antibody negative type 1 DM, 5 (9.8%) as fulminant type 1, 16 (31.4%) as type 2 DM and 8 (15.7%) as secondary DM. Five patients who fulfilled the criteria of fulminant type 1 DM were older (32.2 ± 10.7 vs. 15.7 ± 4.4 years, P = 0.010), had shorter duration of symptoms (4.2 ± 2.7 vs.16.7 ± 15.2 days, P = 0.014) and lower stimulated C-peptide levels (0.1 ± 0.0 vs. 0.7 ± 0.6 ng/mL, P = 0.050) compared with patients with autoimmune type 1 DM. Conclusion: Newly diagnosed diabetic patients presenting with DKA composed of heterogenous types of diabetes. The prevalence of fulminant type 1 diabetes among them was 9.8% and the clinical and biochemical characteristics of these patients were different from those of autoimmune type 1 DM.
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