Subtipos "no clásicos" de diabetes mellitus

Background: Some adult, obese and diabetic patients, initiate their disease with a severe diabetic ketoacidosis without a precipitating factor and do not require insulin thereafter. These patients are classified as having a "non classical" diabetes mellitus. Aim: To study the clinical, imm...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Raddatz K,Verónica, Durruty A,Pilar, Briones B,Gloria, López S,Gloria, Soto I,Néstor, García de los Ríos A,Manuel
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2001
Materias:	Diabetes mellitus Diabetes mellitus, sudden onset Diabetic coma Diabetic ketoacidosis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001000800003
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:scielo:S0034-98872001000800003
record_format	dspace
spelling	oai:scielo:S0034-988720010008000032001-10-29Subtipos "no clásicos" de diabetes mellitusRaddatz K,VerónicaDurruty A,PilarBriones B,GloriaLópez S,GloriaSoto I,NéstorGarcía de los Ríos A,Manuel Diabetes mellitus Diabetes mellitus, sudden onset Diabetic coma Diabetic ketoacidosis Background: Some adult, obese and diabetic patients, initiate their disease with a severe diabetic ketoacidosis without a precipitating factor and do not require insulin thereafter. These patients are classified as having a "non classical" diabetes mellitus. Aim: To study the clinical, immunological, genetic and metabolic features of patients with non classical diabetes mellitus. Patients and methods: Ten patients (9 men, aged 45±12 years old) with non classical diabetes mellitus were studied. Anti islet and anti glutamic acid decarboxylase antibodies (ICA and anti GAD), HLA DQ a arginine 52 and non aspartic ß57 were measured. Insulin secretion was measured by C peptide after glucagon injection and with the minimal model of Bergman. The latter model was also used to determine insulin sensitivity. Results: Three patients were immunologically classified as type 1, since they had positive ICA or antiGAD antibodies and type 1 genetics (neutral or susceptible HLA DQ a and ß). They had insulin secretion after glucagon stimulus (C peptide ranging from 2.2 to 7.5 pmol/ml), but an almost absent response to a glucose load. They were also insulin resistant (a sensitivity index ranging from 0.05 to 1.67 x 10-4 min/µU x ml). These three cases could be categorized as latent type 1. The other seven patients were ICA negative and antiGAD negative. Five had a susceptible HLA genotype for type 1 diabetes and two were neutral. All had insulin secretion after glucagon stimulation and a variable response to glucose. Six were insulin resistant (sensitivity index ranging from 0.32 to 1.29 x 10-4 min/µU x ml). One patient was insulin sensitive (sensitivity index of 3.83 x 10-4 min/µU x ml). Therefore all these patients were classified as type two diabetics with an atypical debut. Conclusions: Not all diabetics presenting with a severe diabetic ketoacidosis are type I. Among these, there are subjects with a latent type 1 diabetes or with an atypical type 2 diabetes (Rev Med Chile 2001; 129: 853-60).info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.129 n.8 20012001-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001000800003es10.4067/S0034-98872001000800003
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Diabetes mellitus Diabetes mellitus, sudden onset Diabetic coma Diabetic ketoacidosis
spellingShingle	Diabetes mellitus Diabetes mellitus, sudden onset Diabetic coma Diabetic ketoacidosis Raddatz K,Verónica Durruty A,Pilar Briones B,Gloria López S,Gloria Soto I,Néstor García de los Ríos A,Manuel Subtipos "no clásicos" de diabetes mellitus
description	Background: Some adult, obese and diabetic patients, initiate their disease with a severe diabetic ketoacidosis without a precipitating factor and do not require insulin thereafter. These patients are classified as having a "non classical" diabetes mellitus. Aim: To study the clinical, immunological, genetic and metabolic features of patients with non classical diabetes mellitus. Patients and methods: Ten patients (9 men, aged 45±12 years old) with non classical diabetes mellitus were studied. Anti islet and anti glutamic acid decarboxylase antibodies (ICA and anti GAD), HLA DQ a arginine 52 and non aspartic ß57 were measured. Insulin secretion was measured by C peptide after glucagon injection and with the minimal model of Bergman. The latter model was also used to determine insulin sensitivity. Results: Three patients were immunologically classified as type 1, since they had positive ICA or antiGAD antibodies and type 1 genetics (neutral or susceptible HLA DQ a and ß). They had insulin secretion after glucagon stimulus (C peptide ranging from 2.2 to 7.5 pmol/ml), but an almost absent response to a glucose load. They were also insulin resistant (a sensitivity index ranging from 0.05 to 1.67 x 10-4 min/µU x ml). These three cases could be categorized as latent type 1. The other seven patients were ICA negative and antiGAD negative. Five had a susceptible HLA genotype for type 1 diabetes and two were neutral. All had insulin secretion after glucagon stimulation and a variable response to glucose. Six were insulin resistant (sensitivity index ranging from 0.32 to 1.29 x 10-4 min/µU x ml). One patient was insulin sensitive (sensitivity index of 3.83 x 10-4 min/µU x ml). Therefore all these patients were classified as type two diabetics with an atypical debut. Conclusions: Not all diabetics presenting with a severe diabetic ketoacidosis are type I. Among these, there are subjects with a latent type 1 diabetes or with an atypical type 2 diabetes (Rev Med Chile 2001; 129: 853-60).
author	Raddatz K,Verónica Durruty A,Pilar Briones B,Gloria López S,Gloria Soto I,Néstor García de los Ríos A,Manuel
author_facet	Raddatz K,Verónica Durruty A,Pilar Briones B,Gloria López S,Gloria Soto I,Néstor García de los Ríos A,Manuel
author_sort	Raddatz K,Verónica
title	Subtipos "no clásicos" de diabetes mellitus
title_short	Subtipos "no clásicos" de diabetes mellitus
title_full	Subtipos "no clásicos" de diabetes mellitus
title_fullStr	Subtipos "no clásicos" de diabetes mellitus
title_full_unstemmed	Subtipos "no clásicos" de diabetes mellitus
title_sort	subtipos "no clásicos" de diabetes mellitus
publisher	Sociedad Médica de Santiago
publishDate	2001
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001000800003
work_keys_str_mv	AT raddatzkveronica subtiposnoclasicosdediabetesmellitus AT durrutyapilar subtiposnoclasicosdediabetesmellitus AT brionesbgloria subtiposnoclasicosdediabetesmellitus AT lopezsgloria subtiposnoclasicosdediabetesmellitus AT sotoinestor subtiposnoclasicosdediabetesmellitus AT garciadelosriosamanuel subtiposnoclasicosdediabetesmellitus
_version_	1718435985609457664

Subtipos "no clásicos" de diabetes mellitus

Ejemplares similares