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Ketosis-prone atypical diabetes in Cameroonian people with hyperglycaemic crisis: frequency, clinical and metabolic phenotypes.
Diabet Med. 2017 03; 34(3):426-431.DM

Abstract

AIM

It is unclear whether ketosis-prone diabetes is a specific type or a subtype of Type 2 diabetes. We aimed to describe the clinical and metabolic features of ketosis-prone diabetes in a sub-Saharan population.

METHODS

We consecutively enrolled and characterized 173 people with non-autoimmune diabetes admitted for hyperglycaemic crisis at the Yaoundé Central Hospital, Cameroon. Blood samples were collected for fasting glucose, HbA1c , lipid profile and C-peptide assays with insulin resistance and secretion estimation by homeostasis model assessment. People were classified as having Type 2 diabetes (n = 124) or ketosis-prone diabetes (n = 49). Ketosis-prone diabetes was sub-classified as new-onset ketotic phase (n = 34) or non-ketotic phase (n = 15).

RESULTS

Ketosis-prone diabetes was found in 28.3% of the hyperglycaemic crises. Age at diabetes diagnosis was comparable in Type 2 and ketosis-prone diabetes [48 ± 14 vs 47 ± 11 years; P = 0.13] with a similar sex distribution. Overall BMI was 27.7 ± 13.4 kg/m2 and was ≥ 25 kg/m2 in 55.8% of those taking part, however, 73.5% of those with ketosis-prone diabetes reported weight loss of > 5% at diagnosis. Blood pressure and lipid profile were comparable in both types. Ketosis-prone diabetes in the ketotic phase was characterized by lower insulin secretion and higher serum triglycerides compared with non-ketotic ketosis prone and Type 2 diabetes. Type 2 and ketosis prone diabetes in the non-ketotic phase were comparable in terms of lipid profile, blood pressure, waist-to-hip ratio, BMI and fat mass, insulin secretion and insulin resistance indices.

CONCLUSIONS

Ketosis-prone diabetes is likely to be a subtype of Type 2 diabetes with the potential to develop acute insulinopenic episodes.

Authors+Show Affiliations

Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon.INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Paris, France.National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon.Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon.Diabetes Research Center, Brussels Free University-VUB, Brussels, Belgium.Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon.INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Paris, France. Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon. National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon. Department of Internal Medicine, University of Yaoundé I, Yaoundé, Cameroon.Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon. National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon. Department of Internal Medicine, University of Yaoundé I, Yaoundé, Cameroon.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27657549

Citation

Lontchi-Yimagou, E, et al. "Ketosis-prone Atypical Diabetes in Cameroonian People With Hyperglycaemic Crisis: Frequency, Clinical and Metabolic Phenotypes." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 34, no. 3, 2017, pp. 426-431.
Lontchi-Yimagou E, Nguewa JL, Assah F, et al. Ketosis-prone atypical diabetes in Cameroonian people with hyperglycaemic crisis: frequency, clinical and metabolic phenotypes. Diabet Med. 2017;34(3):426-431.
Lontchi-Yimagou, E., Nguewa, J. L., Assah, F., Noubiap, J. J., Boudou, P., Djahmeni, E., Balti, E. V., Atogho-Tiedeu, B., Gautier, J. F., Mbanya, J. C., & Sobngwi, E. (2017). Ketosis-prone atypical diabetes in Cameroonian people with hyperglycaemic crisis: frequency, clinical and metabolic phenotypes. Diabetic Medicine : a Journal of the British Diabetic Association, 34(3), 426-431. https://doi.org/10.1111/dme.13264
Lontchi-Yimagou E, et al. Ketosis-prone Atypical Diabetes in Cameroonian People With Hyperglycaemic Crisis: Frequency, Clinical and Metabolic Phenotypes. Diabet Med. 2017;34(3):426-431. PubMed PMID: 27657549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ketosis-prone atypical diabetes in Cameroonian people with hyperglycaemic crisis: frequency, clinical and metabolic phenotypes. AU - Lontchi-Yimagou,E, AU - Nguewa,J L, AU - Assah,F, AU - Noubiap,J J, AU - Boudou,P, AU - Djahmeni,E, AU - Balti,E V, AU - Atogho-Tiedeu,B, AU - Gautier,J F, AU - Mbanya,J C, AU - Sobngwi,E, Y1 - 2016/10/15/ PY - 2016/09/16/accepted PY - 2016/9/23/pubmed PY - 2018/2/21/medline PY - 2016/9/23/entrez SP - 426 EP - 431 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 34 IS - 3 N2 - AIM: It is unclear whether ketosis-prone diabetes is a specific type or a subtype of Type 2 diabetes. We aimed to describe the clinical and metabolic features of ketosis-prone diabetes in a sub-Saharan population. METHODS: We consecutively enrolled and characterized 173 people with non-autoimmune diabetes admitted for hyperglycaemic crisis at the Yaoundé Central Hospital, Cameroon. Blood samples were collected for fasting glucose, HbA1c , lipid profile and C-peptide assays with insulin resistance and secretion estimation by homeostasis model assessment. People were classified as having Type 2 diabetes (n = 124) or ketosis-prone diabetes (n = 49). Ketosis-prone diabetes was sub-classified as new-onset ketotic phase (n = 34) or non-ketotic phase (n = 15). RESULTS: Ketosis-prone diabetes was found in 28.3% of the hyperglycaemic crises. Age at diabetes diagnosis was comparable in Type 2 and ketosis-prone diabetes [48 ± 14 vs 47 ± 11 years; P = 0.13] with a similar sex distribution. Overall BMI was 27.7 ± 13.4 kg/m2 and was ≥ 25 kg/m2 in 55.8% of those taking part, however, 73.5% of those with ketosis-prone diabetes reported weight loss of > 5% at diagnosis. Blood pressure and lipid profile were comparable in both types. Ketosis-prone diabetes in the ketotic phase was characterized by lower insulin secretion and higher serum triglycerides compared with non-ketotic ketosis prone and Type 2 diabetes. Type 2 and ketosis prone diabetes in the non-ketotic phase were comparable in terms of lipid profile, blood pressure, waist-to-hip ratio, BMI and fat mass, insulin secretion and insulin resistance indices. CONCLUSIONS: Ketosis-prone diabetes is likely to be a subtype of Type 2 diabetes with the potential to develop acute insulinopenic episodes. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/27657549/Ketosis_prone_atypical_diabetes_in_Cameroonian_people_with_hyperglycaemic_crisis:_frequency_clinical_and_metabolic_phenotypes_ L2 - https://doi.org/10.1111/dme.13264 DB - PRIME DP - Unbound Medicine ER -