당뇨병성 케톤산증 발생으로 당뇨병이 처음 진단된 환자의 병형 분류: 전격성 제1형 당뇨병의 임상적 특징 (The Classification of Diabetic Patients Presenting Diabetic Ketoacidosis: The Characteristics of Fulminant Type 1 Diabetes)

서지정보

· 발행기관 : 대한당뇨병학회
· 수록지 정보 : Diabetes and Metabolism Journal / 32권 / 5호 / 428 ~ 434페이지
· 저자명 : 장은희, 이정은, 이승재, 전상훈, 백기현, 송기호, 유순집, 이종민, 윤건호, 강무일, 이광우, 김미경

초록

Background: The aim of the study was to classify newly diagnosed diabetic patients who initially presented
with diabetic ketoacidosis (DKA) into specific types of diabetes and to describe the clinical and biochemical
characteristics of patients with fulminant type 1 DM in Korea.
Methods: Using data from 4 hospitals of CMC from 1 January 1999 to 1 March 2008, we identified all
patients who manifested DKA when they were first diagnosed as diabetes. Clinical and laboratory data were
reviewed from medical records.
Results: We identified 51 newly diagnosed diabetic patients manifested DKA. Among them, 14 (27.4%)
patients were classified as autoimmune type 1 DM, 8 (15.7%) as antibody negative type 1 DM, 5 (9.8%) as
fulminant type 1, 16 (31.4%) as type 2 DM and 8 (15.7%) as secondary DM. Five patients who fulfilled the
criteria of fulminant type 1 DM were older (32.2 ± 10.7 vs. 15.7 ± 4.4 years, P = 0.010), had shorter duration
of symptoms (4.2 ± 2.7 vs.16.7 ± 15.2 days, P = 0.014) and lower stimulated C-peptide levels (0.1 ± 0.0 vs.
0.7 ± 0.6 ng/mL, P = 0.050) compared with patients with autoimmune type 1 DM.
Conclusion Newly diagnosed diabetic patients presenting with DKA composed of heterogenous types of
diabetes. The prevalence of fulminant type 1 diabetes among them was 9.8% and the clinical and biochemical
characteristics of these patients were different from those of autoimmune type 1 DM. (KOREAN DIABETES
J 32:428-434, 2008)

영어초록

Background: The aim of the study was to classify newly diagnosed diabetic patients who initially presented
with diabetic ketoacidosis (DKA) into specific types of diabetes and to describe the clinical and biochemical
characteristics of patients with fulminant type 1 DM in Korea.
Methods: Using data from 4 hospitals of CMC from 1 January 1999 to 1 March 2008, we identified all
patients who manifested DKA when they were first diagnosed as diabetes. Clinical and laboratory data were
reviewed from medical records.
Results: We identified 51 newly diagnosed diabetic patients manifested DKA. Among them, 14 (27.4%)
patients were classified as autoimmune type 1 DM, 8 (15.7%) as antibody negative type 1 DM, 5 (9.8%) as
fulminant type 1, 16 (31.4%) as type 2 DM and 8 (15.7%) as secondary DM. Five patients who fulfilled the
criteria of fulminant type 1 DM were older (32.2 ± 10.7 vs. 15.7 ± 4.4 years, P = 0.010), had shorter duration
of symptoms (4.2 ± 2.7 vs.16.7 ± 15.2 days, P = 0.014) and lower stimulated C-peptide levels (0.1 ± 0.0 vs.
0.7 ± 0.6 ng/mL, P = 0.050) compared with patients with autoimmune type 1 DM.
Conclusion Newly diagnosed diabetic patients presenting with DKA composed of heterogenous types of
diabetes. The prevalence of fulminant type 1 diabetes among them was 9.8% and the clinical and biochemical
characteristics of these patients were different from those of autoimmune type 1 DM. (KOREAN DIABETES
J 32:428-434, 2008)

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