Young Chinese adults with new onset of diabetic ketoacidosis - Clinical course, autoimmune status and progression of pancreatic β-cell function

Aims: To examine the clinical course, autoimmune status and pancreatic β cell function, over a 2-year period, in young Chinese subjects newly presenting with diabetic ketoacidosis (DKA). Methods: A prospective study involving 562 out of 27 893 patients who were admitted to the medical ward with a principal diagnosis of diabetes mellitus during the recruitment period of 1 year. Results: Of these 562 patients, 27 were aged less than 35 years and admitted with a diagnosis of DKA and 11 (six males and five females) of these were newly diagnosed. Antibodies to glutamic acid decarboxylase (GAD) were present in five patients. Anti-ICA 512 was not detected in any of the patients. Basal and post-glucagon stimulated plasma C-peptide remained in the insulin-deficient range although showing improvement at 2 years. Conclusions: These findings confirm the relative rarity of autoimmune Type 1 diabetes in young Chinese. Even when the clinical presentation takes the extreme form of acute DKA, less than 50% have positive autoimmune markers.