A Case of Autoantibody-Positive Ketosis-Prone Diabetes Mellitus.

Yoon,  Bora; Kim,  Gyuri; Bae,  Jae Hyun; Yun,  Yu Jung; Lee,  Yong Ho; Lee,  Byung Wan; Ahn,  Chul Woo; Cha,  Bong Soo; Lee,  Hyun Chul; Kang,  Eun Seok

doi:2016.17.1.60

J Korean Diabetes > Volume 17(1); 2016 > Article

Case Report

The Journal of Korean Diabetes 2016;17(1):60-66.
DOI: https://doi.org/10.4093/jkd.2016.17.1.60 Published online April 12, 2016.

자가항체 양성인 Ketosis-Prone 당뇨병 1예

윤보라, 김규리, 배재현, 윤유정, 이용호, 이병완, 안철우, 차봉수, 이현철, 강은석

A Case of Autoantibody-Positive Ketosis-Prone Diabetes Mellitus.

Bora Yoon, Gyuri Kim, Jae Hyun Bae, Yu Jung Yun, Yong Ho Lee, Byung Wan Lee, Chul Woo Ahn, Bong Soo Cha, Hyun Chul Lee, Eun Seok Kang

Department of Internal Medicine, Yonsei University College of Medicine, Korea. edgo@yuhs.ac

Abstract

Ketosis-prone diabetes mellitus (KPD), which is an atypical type of diabetic mellitus with severe β cell dysfunction, is accompanied by ketosis or ketoacidosis without specific preceding factors at diagnosis. KPD shows mixed features of type 1 and type 2 diabetes. In some cases, the recovery of the function of β cells during intensified diabetic management enabled the termination of insulin therapy. The Aβ classification system classifies KPD patients into four distinct subgroups depending upon the presence or absence of β cell autoimmunity and β cell functional reserve and has been recognized as an important tool to predict clinical outcomes. In Korea, several cases of KPD with absence of β cell autoimmunity have been reported. A 60-year-old man presenting with DKA (diabetic ketoacidosis) as the first manifestation of diabetes, was shown to have β cell autoimmunity. A significant improvement in glycemic control was shown as a result of aggressive diabetic management; shortly after an acute episode of DKA, the recovery of β cell functional reserve was confirmed. This result allowed discontinuation of insulin therapy and maintenance of euglycemic status without antidiabetic medication.

Key Words: Diabetic ketoacidosis, Type 2 diabetes mellitus