Epidemiological Investigation And The Main Laboratory Data Of The Ketoacidosis Onset Of Fulminant Type 1 Diabetes

Objective:To investigate the prevalence and explore the laboratory data features of DKA-onset fulminant type 1 diabetes with the new diagnostic criteria.Methods:①Analyzed 238 cases of DKA(including repeat hospitalized patients) in the Ninth Affiliated Hospital of Guangxi Medical University from January 2003 to December 2013. With the diagnosis criteria proposed by Imagawa(2012),7 cases of DKA-onset FTIDM were screen from the admitted DKA patients.Combined with 182 cases of DKA-onset FTIDM had been reported in our Country,their epidemiological features were analyzed.②7 cases of DKA-onset FT1DM screened in the Ninth Affiliated Hospital of Guangxi Medical University.Combined with 18 cases which had been reported in our Country,their laboratory data were analyzed.③The cases of DKA-onset T2DM were screened as group A and the cases of DKA-onset T1DM (not FT1DM) as group B from 238 cases of DKA patients which mentioned above,25 cases of DKA-onset FTIDM which were mentioned above as group C.The laboratory data were compared among 3 groups. Then the cases of course within 3 months were screened as group A1 from group A, and the cases of course within 3 months were screened as group B1 from group B,the laboratory data were compared among group C,groupA1, group B1 again. Then the cases of course within a week were screened as group A2 from group A1,and the cases of course within a week were screened as group B2from group Bl,the laboratory data were compared among group C,groupA2 and group B2 again.Results:①7 cases of FT1DM were screened from 238 cases of consecutive hospitalized diabetics ketoacidosis,95 cases DKA-onset newly diagnosed diabetes(47 cases T1DM). FT1DM accounted for about 2.9%(7/238) in the consecutive hospitalized diabetes cases of DKA,7.1%(7/99) in ketoacidosis-onset hospitalized T1DM,7.4%(7/95) in DKA-onset of newly diagnosed diabetes cases, and 14.9%(7/47) in the DKA-onset of type 1 diabetes cases in the Ninth Affiliated Hospital of Guangxi Medical University. By 2013, a total of 189 cases of DKA-onset FT1DM had been reported in our country, which 146 cases in southern,43 cases in northern,and the diagnose age was 2～ 71 years old.②Among 25 cases of DKA-onset FT1DM::10 were male,15 were female,19 wre Southern,6 were northern,8 were pregnancy-related,11 were <30 years,14 were>30 years.There were no statistical difference regarding the laboratory datas(serum glucose,HbAlc level,pH,serum sodium,serum potassium) between the two group(male vs female, south vs north, pregnancy-associated vs not associated with pregnancy,≤30years old vs>30years old).③Group C of the serum glucose, serum potassium were significantly higher than that of group A,group B, group A1, group B1, group A2, group B2, and HbA1c was significantly lower than that of group A, group B, group A1, group B1, group A2 and group B2. Group C of serum sodium, pH were significantly lower than that of group A, group A1, group B of serum was significantly lower than that of group A.The rest were no statistical significance.Conclusion:1. The DKA-onset FTIDM is sporadic, occupie a certain proportion in the DKA-onset diabetes patients.2.The DKA-onset FT1DM patients’HbAlc are less than 8.7% and they share low level of pH, serum sodium and high level of serum glucose, serum potassium.3. The DKA-onset FTIDM patients of serum glucose,serum potassium are higher than that the DKA-onset non-fulminant of T1DM, DKA-onset T2DM, and HbA1c is lower than that the DKA-onset non-fulminant T1DM,DKA-onset T2DM in the early onset,the course affect the result of the comparison.