Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan.
J Diabetes Investig. 2020 Mar;11(2):499-501. doi: 10.1111/jdi.13120. Epub 2019 Aug 14.
Ketosis-prone type 2 diabetes is recognized as atypical diabetes. These patients are often male, characterized by obesity, sudden onset of ketosis and a transient decrease in insulin secretion capacity that can be recovered with temporal insulin therapy. Here, we report a male patient with ketosis-prone type 2 diabetes who was followed up for 8 years. During the follow-up period, his bodyweight fluctuated and he experienced four episodes of critical ketosis recurrence in association with bodyweight gain. He discontinued insulin therapy after each ketosis episode within the first 4 years, but thereafter, he had to continue insulin therapy because of decreased insulin secretion capacity. Interestingly, his peak bodyweight just before the repeated ketosis episode gradually decreased, and the insulin secretion capacity after the recovery from repeated ketosis decreased in parallel with his peak bodyweight. This long-term clinical course might be a clue to understand the pathophysiology of ketosis-prone type 2 diabetes.
易酮症倾向 2 型糖尿病被认为是一种非典型糖尿病。这些患者通常为男性，以肥胖、酮症突然发作和胰岛素分泌能力短暂下降为特征，经短暂胰岛素治疗后可恢复。在这里，我们报告了一名易酮症倾向 2 型糖尿病男性患者，他接受了 8 年的随访。在随访期间，他的体重波动，并经历了 4 次与体重增加相关的严重酮症复发。在最初 4 年内，他在每次酮症发作后停止胰岛素治疗，但此后，由于胰岛素分泌能力下降，他不得不继续胰岛素治疗。有趣的是，他在反复酮症发作前的峰值体重逐渐下降，而在反复酮症恢复后的胰岛素分泌能力与他的峰值体重呈平行下降。这种长期的临床病程可能是理解易酮症倾向 2 型糖尿病病理生理学的线索。
