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[Clinical characteristics and classification diagnosis of newly diagnosed diabetes onset with ketosis or ketoacidosis in adult patients].
Zhonghua Yi Xue Za Zhi. 2019 May 14; 99(18):1369-1374.ZY

Abstract

Objective:

To describe the clinical characteristics and classification diagnosis of newly diagnosed diabetes onset with ketosis or ketoacidosis in adult patients.

Methods:

Medical records of newly diagnosed diabetes onset with ketosis or ketoacidosis in the Third Affiliated Hospital of Sun Yat-sen University between January 2011 and August 2016 were reviewed. Patients aged 18 years or older were included, while other diseases that may cause urinary ketoacidosis and special types of diabetes were excluded. Patients were classified as type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) or diabetes mellitus untyped based on discharged diagnosis, and groups were compared for differences in clinical profiles. Then the patient's medication, final diagnosis and outcome within 2 years of discharge were tracked through the inpatient and the outpatient medical record systems. Receiver operating characteristics (ROC) curves were analyzed to check the ability of clinical indicators such as onset age, body mass index (BMI) and C-peptide to discriminate T1DM from T2DM, and to find the best diagnostic cut-off points.

Results:

A total of 123 patients (88 males) were enrolled [with a mean age of (41.1±13.6) years old], with 37 patients (30.1%) diagnosed as T1DM, 60 patients (48.8%) diagnosed as T2DM and 26 patients (21.1%) diagnosed as Untyped. There was a statistically significant difference in onset age, BMI, blood pressure, blood gas pH and bicarbonate, blood lipids, fasting, 0.5 h and 2 h C-peptide level, any diabetic antibody and anti-glutamic acid decarboxylase antibody (GADA) positive rate, combined fatty liver ratio and family history among the three groups (all P<0.05). ROC curve analysis was performed on patients diagnosed with T1DM (n=36) and T2DM (n=87) after 2 years follow-up, and the area under the curve (AUC) of onset age, BMI, fasting C-peptide, 0.5 h and 2 h C-peptide was 0.735, 0.813, 0.855, 0.898, and 0.882, respectively.

Conclusion:

The ROC curve analysis indicates that C-peptide, onset age and BMI can provide effective diagnostic value, and the diagnostic value of C peptide is better than BMI and onset age.

Authors+Show Affiliations

Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.Department of Endocrinology, Qujing First People's Hospital, Qujing 655000, Yunnan, China.Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

31137122

Citation

Liu, H X., et al. "[Clinical Characteristics and Classification Diagnosis of Newly Diagnosed Diabetes Onset With Ketosis or Ketoacidosis in Adult Patients]." Zhonghua Yi Xue Za Zhi, vol. 99, no. 18, 2019, pp. 1369-1374.
Liu HX, Li GM, Zhou YW, et al. [Clinical characteristics and classification diagnosis of newly diagnosed diabetes onset with ketosis or ketoacidosis in adult patients]. Zhonghua Yi Xue Za Zhi. 2019;99(18):1369-1374.
Liu, H. X., Li, G. M., Zhou, Y. W., Luo, S. H., Zheng, X. Y., Yang, D. Z., Liang, H., Yan, J. H., Yao, B., & Weng, J. P. (2019). [Clinical characteristics and classification diagnosis of newly diagnosed diabetes onset with ketosis or ketoacidosis in adult patients]. Zhonghua Yi Xue Za Zhi, 99(18), 1369-1374. https://doi.org/10.3760/cma.j.issn.0376-2491.2019.18.003
Liu HX, et al. [Clinical Characteristics and Classification Diagnosis of Newly Diagnosed Diabetes Onset With Ketosis or Ketoacidosis in Adult Patients]. Zhonghua Yi Xue Za Zhi. 2019 May 14;99(18):1369-1374. PubMed PMID: 31137122.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical characteristics and classification diagnosis of newly diagnosed diabetes onset with ketosis or ketoacidosis in adult patients]. AU - Liu,H X, AU - Li,G M, AU - Zhou,Y W, AU - Luo,S H, AU - Zheng,X Y, AU - Yang,D Z, AU - Liang,H, AU - Yan,J H, AU - Yao,B, AU - Weng,J P, PY - 2019/5/29/entrez PY - 2019/5/30/pubmed PY - 2019/6/5/medline KW - Diabetes mellitus, type 1 KW - Diabetes mellitus, type 2 KW - Diabetic ketoacidosis SP - 1369 EP - 1374 JF - Zhonghua yi xue za zhi JO - Zhonghua Yi Xue Za Zhi VL - 99 IS - 18 N2 - Objective: To describe the clinical characteristics and classification diagnosis of newly diagnosed diabetes onset with ketosis or ketoacidosis in adult patients. Methods: Medical records of newly diagnosed diabetes onset with ketosis or ketoacidosis in the Third Affiliated Hospital of Sun Yat-sen University between January 2011 and August 2016 were reviewed. Patients aged 18 years or older were included, while other diseases that may cause urinary ketoacidosis and special types of diabetes were excluded. Patients were classified as type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) or diabetes mellitus untyped based on discharged diagnosis, and groups were compared for differences in clinical profiles. Then the patient's medication, final diagnosis and outcome within 2 years of discharge were tracked through the inpatient and the outpatient medical record systems. Receiver operating characteristics (ROC) curves were analyzed to check the ability of clinical indicators such as onset age, body mass index (BMI) and C-peptide to discriminate T1DM from T2DM, and to find the best diagnostic cut-off points. Results: A total of 123 patients (88 males) were enrolled [with a mean age of (41.1±13.6) years old], with 37 patients (30.1%) diagnosed as T1DM, 60 patients (48.8%) diagnosed as T2DM and 26 patients (21.1%) diagnosed as Untyped. There was a statistically significant difference in onset age, BMI, blood pressure, blood gas pH and bicarbonate, blood lipids, fasting, 0.5 h and 2 h C-peptide level, any diabetic antibody and anti-glutamic acid decarboxylase antibody (GADA) positive rate, combined fatty liver ratio and family history among the three groups (all P<0.05). ROC curve analysis was performed on patients diagnosed with T1DM (n=36) and T2DM (n=87) after 2 years follow-up, and the area under the curve (AUC) of onset age, BMI, fasting C-peptide, 0.5 h and 2 h C-peptide was 0.735, 0.813, 0.855, 0.898, and 0.882, respectively. Conclusion: The ROC curve analysis indicates that C-peptide, onset age and BMI can provide effective diagnostic value, and the diagnostic value of C peptide is better than BMI and onset age. SN - 0376-2491 UR - https://www.unboundmedicine.com/medline/citation/31137122/[Clinical_characteristics_and_classification_diagnosis_of_newly_diagnosed_diabetes_onset_with_ketosis_or_ketoacidosis_in_adult_patients]_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -