The Characteristics Of Unprovoked Ketosis-prone Diabetes Mellitus

Objective:1. To evaluate the difference between classical T1DM and LAD A.2. To evaluate the characteristics of T1BDM and ADM,and to evaluate if ADM can be classified into T1BDM or T2DM. To evaluate the probable factor which associated with the occurrence of the unprovoked diabetic ketoacidosis (DKA) or ketosis (DK).Methods:We reviewed diabetic patients with DKA and DK in Nanjing Drum Tower a Hospital from January 1,2006 to January 1,2013. patients with acute onset diabetes were divided into classical T1DM subgroup, T1BDM subgroup and ADM subgroup; chronic-onset diabetes were divided into LADA subgroup and T2DM subgroup. And groups were compared for differences in vital statistics and biochemical profiles at presentation.Results:1. The most common contributing factor for DKA was infection, and then was drugs omission.2. TIBDMs account for 36% of the new onset T1DM.3. The positive rate of GADA was 63.83%.4. Lower HbA1c level and lower TG level may contribute to prevent the occurrence of DK in T1DM patients.5. ADM has some characteristics of T1DM and T2DM; Ketosis-prone patient may have higher genetic tendency.6. T1BDM patients’ average age is the youngest and T2DM patients’ the oldest (P<0.001); The average BMI level of the ADMs and T2DMs was higher than TIBDMs’(P<0.001); The percentage of family history in ADMs and TIBDMs is higher than that in T2DMs (P<0.05); The percentage of MS in TIBDMs is lowest and that in T2DMs is highest (P<0.001); The percentage of fatty liver in ADMs and T2DMs was higher than that in T1BDMs; The average TG level of the ADMs and T2DMs was higher than TIBDMs’(P<0.05); The average FCP and 2hCP levels of T2DM patients and ADM patients were higher than that of T1BDM patients (P<0.001).Conclusions:The most common contributing factor for DKA was infection, and then was drugs omission; The positive rate of GAD A was the highest; Lower HbA1c level and lower TG level may contribute to prevent the occurrence of DK or DKA in T1DM patients; T1BDM and ADM patients were not rare in unprovoked ketosis-prone diabetes; The characteristics of ADM is more likely to that of T2DM, so may be ADM should be classified into T2DM; The patients with a T2DM history may have a unprovoked DK or DKA tendency.