Characteristics of diabetic ketoacidosis in Chinese adults and adolescents – A teaching hospital-based analysis

Tan, Huiwen; Zhou, Yunxia; Yu, Yerong

doi:10.1016/j.diabres.2012.05.004

Cited by 43 publications

(59 citation statements)

References 17 publications

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“…Interestingly, various studies conducted in developed countries report occurrence of DKA in T1DM patients [3,4,15]. Contrarily, the studies conducted in Asia, South East Asia and Polynesia, reported T2DM to be more common among the patients of DKA [12,13]. Parallel with the regional findings, Huri et al reported frequent occurrence of DKA in T2DM patients [5].…”

Section: Discussionsupporting

confidence: 68%

“…As per patient profiles analyzed in our study, we estimated incidence rate of DKA to be 5.47 % (54.7 per 1000 diabetic admissions) for multiethnic diabetic population of Malaysia. We found this rate to be parallel with the estimated rate of DKA for Malaysia and reported rates for Thailand and China [5,12,13]. …”

Section: Discussionsupporting

confidence: 64%

“…We, however, recorded 19 established cases of thyrotoxicosis patients in our study. Among the precipitating factors for an episode of DKA, infection and nonadherence to DM management are, more or less, equally reported [5][6][7]12,13]. In our research, most patients did not have any impulsive cause for development of DKA.…”

Section: Discussionmentioning

confidence: 51%

“…With passage of time, it was also found to be associated with T2DM and NDDM patients when numbers of these patients were reported to present with DKA [15]. In recent past, more studies reporting similar findings in such context give a notion that although the incidence of DKA in T2DM may be less, but since prevalence of T2DM exceeds T1DM, DKA is thus more or less observed equally in both arms [12]. Interestingly, various studies conducted in developed countries report occurrence of DKA in T1DM patients [3,4,15].…”

Section: Discussionmentioning

confidence: 71%

“…Being an acute co-morbidity, the recorded incidence rate for DKA varies from 4.6 to 8 out of 1000 diabetic admissions in developed nations [3]. However, it is reported to be higher in Asia, Africa and Polynesia [11][12][13]. Huri et al reported 256 DKA cases over 5 years in Malaysia that was slightly higher when compared with neighboring countries [5].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Profiles of Diabetic Ketoacidosis in Multiethnic Diabetic Population of Malaysia

Usman¹,

Sulaiman²,

Khan³

et al. 2015

Trop. J. Pharm Res

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Section: Discussionsupporting

confidence: 68%

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Profiles of Diabetic Ketoacidosis in Multiethnic Diabetic Population of Malaysia

Usman¹,

Sulaiman²,

Khan³

et al. 2015

Trop. J. Pharm Res

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show abstract

Clinical heterogeneity of type 1 diabetes (T1D) found in Asia

Park

Wintergerst

Zhou

2017

Diabetes Metabolism Res

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Diabetes mellitus among young patients in Asia is caused by a complex set of factors. Although type 1 diabetes (T1D) remains the most common form of diabetes in children, the recent unabated increase in obesity has resulted in the emergence of type 2 diabetes (T2D) as a new type of diabetes among adolescents and young adults. In addition to the typical autoimmune type 1 diabetes (T1aD) and T2D patients, there is a variable incidence of cases of non-autoimmune types of T1D associated with insulin deficiency (T1bD). Additional forms have been described, including fulminant T1D (FT1D). Although most diagnoses of T1D are classified as T1aD, fulminant T1D exists as a hyper-acute subtype of T1D that affects older children, without associated autoimmunity. Patient with this rare aetiology of diabetes showed a complete loss of β-cell secretory capacity without evidence of recovery, necessitating long-term treatment with insulin. In addition, latent autoimmune diabetes in adults is a form of autoimmune-mediated diabetes, usually diagnosed during the insulin-dependent stage that follows a non-insulin requiring phase, which can be diagnosed earlier based on anti-islet autoantibody positivity. Some reports discuss T1bD. Others are elaborating on the presence of "atypical T1b diabetes," such as Flatbush diabetes. The prevalence of diabetes mellitus in young adults continues to rise in Asian populations as T2D increases. With improved characterization of patients with diabetes, the range of diabetic subgroups will become even more diverse in the future. Distinguishing T1D, T2D, and other forms of diabetes in young patients is challenging in Asian populations, as the correct diagnosis is clinically important and has implications for prognosis and management. Despite aetiological heterogeneity in the usual clinical setting, early diagnosis and classification of patients with diabetes relying on clinical grounds as well as measuring islet autoantibodies and fasting plasma C-peptide could provide a possible viable method to minimize complications.

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One third of cases of new‐onset diabetic ketosis in adults are associated with ketosis‐prone type 2 diabetes—A systematic review and meta‐analysis

Kovacs,

Bunduc,

Veres

et al. 2023

Diabetes Metabolism Res

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AimsKetosis‐prone type 2 diabetes was defined by the World Health Organization in 2019. According to the literature, the diagnosis is based on the presence of ketosis, islet autoantibody negativity and preserved insulin secretion. Our meta‐analysis assessed the prevalence and clinical characteristics of ketosis‐prone type 2 diabetes among patients hospitalised with diabetic ketoacidosis (DKA) or ketosis.MethodsThe systematic search was performed in five main databases as of 15 October 2021 without restrictions. We calculated the pooled prevalence of ketosis‐prone type 2 diabetes (exposed group) within the diabetic population under examination, patients with ketoacidosis or ketosis, to identify the clinical characteristics, and we compared it to type 1 diabetes (the comparator group). The random effects model provided pooled estimates as prevalence, odds ratio and mean difference (MD) with 95% confidence intervals.ResultsEleven articles were eligible for meta‐analysis, thus incorporating 2010 patients of various ethnic backgrounds. Among patients presenting with DKA or ketosis at the onset of diabetes, 35% (95% CI: 24%–49%) had ketosis‐prone type 2 diabetes. These patients were older (MD = 11.55 years; 95% CI: 5.5–17.6) and had a significantly higher body mass index (BMI) (MD = 5.48 kg/m2; 95% CI: 3.25–7.72) than those with type 1 diabetes.ConclusionsKetosis‐prone type 2 diabetes accounts for one third of DKA or ketosis at the onset of diabetes in adults. These patients are characterised by islet autoantibody negativity and preserved insulin secretion. They are older and have a higher BMI compared with type 1 diabetes. C‐peptide and diabetes‐related autoantibody measurement is essential to identify this subgroup among patients with ketosis at the onset of diabetes.

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Characteristics of diabetic ketoacidosis in Chinese adults and adolescents – A teaching hospital-based analysis

Cited by 43 publications

References 17 publications

Profiles of Diabetic Ketoacidosis in Multiethnic Diabetic Population of Malaysia

Profiles of Diabetic Ketoacidosis in Multiethnic Diabetic Population of Malaysia

Clinical heterogeneity of type 1 diabetes (T1D) found in Asia

One third of cases of new‐onset diabetic ketosis in adults are associated with ketosis‐prone type 2 diabetes—A systematic review and meta‐analysis

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