Remission in Ketosis-Prone Diabetes

Endocrinol Metab Clin North Am. 2023 Mar;52(1):165-174. doi: 10.1016/j.ecl.2022.06.005. Epub 2022 Nov 4.

Abstract

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.

Keywords: Atypical diabetes; Autoantibodies; Beta-cell; C-peptide; Diabetic ketoacidosis; Insulin; Ketosis-prone diabetes; Remission.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / drug therapy
  • Diabetic Ketoacidosis* / diagnosis
  • Diabetic Ketoacidosis* / etiology
  • Diabetic Ketoacidosis* / therapy
  • Humans
  • Insulin / therapeutic use

Substances

  • Insulin
  • Biomarkers