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BMJ Case Reports 2013; doi:10.1136/bcr-2012-007704
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Atypical diabetes in children: ketosis-prone type 2 diabetes

  1. Shaun Gorman
  1. Department of Paediatrics, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
  1. Correspondence to Dr Atul Vaibhav, atulvaibhav{at}hotmail.com

Summary

Ketosis-prone type 2 diabetes mellitus also known as atypical or flatbush diabetes is being increasingly recognised worldwide. These patients are typically obese, middle-aged men with a strong family history of type 2 diabetes. The aetiology and pathophysiological mechanism is still unclear but some initial research suggests that patients with ketosis-prone type 2 diabetes have a unique predisposition to glucose desensitisation. These patients have negative autoantibodies typically associated with type 1 diabetes but have shown to have human leucocyte antigen (HLA) positivity. At initial presentation, there is an impairment of both insulin secretion and action. β Cell function and insulin sensitivity can be markedly improved by initiating aggressive diabetes management to allow for discontinuation of insulin therapy within a few months of treatment. These patients can be maintained on oral hypoglycaemic agents and insulin therapy can be safely discontinued after few months depending on their β cell function.

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