Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, Unit 1461, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, BCM 179A, One Baylor Plaza, Houston, TX 77030, USA.
Endocrinol Metab Clin North Am. 2023 Mar;52(1):165-174. doi: 10.1016/j.ecl.2022.06.005. Epub 2022 Nov 4.
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.
酮症倾向糖尿病(KPD)的异质形式的特点是患者表现为糖尿病酮症酸中毒(DKA),但缺乏自身免疫性 T1D 的典型特征和生物标志物。KPD 的 A-β+亚组为“缓解”的概念提供了独特的见解,因为这些患者β细胞功能有相当大的保留,允许在最初表现为 DKA 的情况下停止胰岛素治疗。C 肽水平的测量对于预测缓解和指导潜在的胰岛素停药至关重要。进一步研究缓解和复发的预测因素可以帮助我们指导 A-β+KPD 患者实现缓解,并为这种非典型糖尿病开发靶向治疗。