Endocrinology and metabolism clinics of North America 2022 Nov 04
Remission in Ketosis-Prone Diabetes.
Abstract
Heterogeneous forms of Ketosis-prone diabetes (KPD) are characterized by patients who present with diabetic ketoacidosis (DKA) but lack the typical features and biomarkers of autoimmune T1D. The A-β+ subgroup of KPD provides unique insight into the concept of "remission" since these patients have substantial preservation of beta-cell function permitting the discontinuation of insulin therapy, despite initial presentation with DKA. Measurements of C-peptide levels are essential to predict remission and guide potential insulin withdrawal. Further studies into predictors of remission and relapse can help us guide patients with A-β+ KPD toward remission and develop targeted treatments for this form of atypical diabetes.
Related Questions
How long after a DKA episode do you anticipate patients with ketosis prone diabetes mellitus to be able to discontinue insulin therapy?
If the patient is antibody negative with beta cell function, they can usually discontinue insulin 1 to 2 months after the initial diabetic ketoacidosis (DKA) event (I typically order the antibodies and C-peptide at their first follow-up visit and then will start to pull off insulin once I have the r...
What is the preferred first-line non-insulin agent in patients with ketosis-prone diabetes during "remission" and evidence of preserved beta cell function?
Ketosis-prone diabetes (KPD) is an atypical form of diabetes that has been found in various racial and ethnic groups (Asian Indian, South American, West African, African American and others). People with KPD may present with DKA without the autoimmune findings of Type 1 diabetes. After the DKA episo...