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Journal of Diabetes Research
Volume 2014, Article ID 510643, 6 pages
http://dx.doi.org/10.1155/2014/510643
Clinical Study

Ketosis Onset Type 2 Diabetes Had Better Islet -Cell Function and More Serious Insulin Resistance

Department of Endocrinology & Metabolism, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong 519000, China

Received 28 December 2013; Revised 13 March 2014; Accepted 16 March 2014; Published 13 April 2014

Academic Editor: Chen Li

Copyright © 2014 Hongyun Lu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Diabetic ketosis had been identified as a characteristic of type 1 diabetes mellitus (T1DM), but now emerging evidence has identified that they were diagnosed as T2DM after long time follow up. This case control study was aimed at comparing the clinical characteristic, -cell function, and insulin resistance of ketosis and nonketotic onset T2DM and providing evidence for treatment selection. 140 cases of newly diagnosed T2DM patients were divided into ketosis (62 cases) and nonketotic onset group (78 cases). After correction of hyperglycemia and ketosis with insulin therapy, plasma C-peptide concentrations were measured at 0, 0.5, 1, 2, and 3 hours after 75 g glucose oral administration. Area under the curve (AUC) of C-peptide was calculated. Homoeostasis model assessment was used to estimate basal -cell function (HOMA- ) and insulin resistance (HOMA-IR). Our results showed that ketosis onset group had higher prevalence of nonalcoholic fatty liver disease (NAFLD) than nonketotic group ( ). Ketosis onset group had increased plasma C-peptide levels at 0 h, 0.5 h, and 3 h and higher , , ( ). Moreover, this group also had higher HOMA- and HOMA-IR than nonketotic group ( ). From these data, we concluded that ketosis onset T2DM had better islet -cell function and more serious insulin resistance than nonketotic onset T2DM.