The accepted knowledge is that Diabetes destroys gradually over years. Ketosis Prone Type 2 diabetes is an acute form of type 2. This type 2 can reach fasting blood sugars of 300 or higher in months. This blog brings together all the documentation that I could find in the world and my speculation of what it means for KPD’s in specific and diabetics in general. I ask you to leave your stories about what happened to you so that we can all gain a better understanding of what we are dealing with.

Thursday, April 7, 2011

Who gets KPD T2? Everybody!

I've decided to keep updating this with citations as they come in.



Adult-Onset Atypical (Type 1) Diabetes: Additional Insights And Differences With Type 1a Diabetes In A European Mediterranean Population. Http://Www.Ncbi.Nlm.Nih.Gov/Pubmed/15111529

Clinical characteristics of Korean patients with new-onset diabetes presenting with diabetic ketoacidosis.

Ketosis-onset diabetes in Tunisian adults: immunological markers and β-cell function 

High Frequency of Type 1B (Idiopathic) Diabetes in North Indian Children With Recent-Onset Diabetes

A Subtype of Markedly Abrupt Onset With Absolute Insulin Deficiency in Idiopathic Type 1 Diabetes in Japanese Children

South Asian version of flatbush diabetes mellitus- A case report and review article

Ketoacidosis in Apache Indians with non-insulin-dependent diabetes mellitus

Cetoacidosis diabética:una complicación frecuente de la diabetes tipo 2 en hispanoamericanos

The Occurrence of Diabetic Ketoacidosis in Type 2 Diabetic Chinese Adults

Characteristics of Caucasian type 2 diabetic patients during ketoacidosis and at follow-up

The prevalence of ketosis-prone type 2 diabetes is not known, but observational studies suggest that this type of diabetes accounts for a substantial number of patients with diabetic ketoacidosis. In the United States, the prevalence has been estimated to be between 20% and 50% in African-American and Hispanic patients with new diagnoses of diabetic ketoacidosis . In addition to ethnicity, clinical features predictive of future near-normoglycemic remission are obesity and a family history of type 2 diabetes. Among 154 consecutive African-American patients admitted to the hospital with diabetic ketoacidosis, we observed that obesity was present in 29% and that the prevalence of obesity was higher among those with newly diagnosed diabetes (56%). More than 80% of patients have a family history of type 2 diabetes. The mean body mass index at presentation in African-American patients with ketosis-prone type 2 diabetes has ranged between 28 kg/m2 to 37 kg/m2 . A high rate of obesity is also reported in Hispanic and Chinese persons and in sub-Saharan black African immigrants to Europe. Obesity in persons with diabetic ketoacidosis from minority ethnic groups is more common than in white persons, in whom the rate of obesity is less than 20%.

Balasubramanyan and colleagues reviewed the clinical profiles of 141 adults admitted to the hospital with diabetic ketoacidosis. At presentation, 39% of patients were considered to have type 1 diabetes, 53% were considered to have type 2 diabetes, and 8% were not classified.Twenty-eight percent of patients had newly diagnosed diabetes, 93% of whom were reassessed at least 2 years after their initial episode of diabetic ketoacidosis and were considered to have type 2 diabetes. More recently, Pin˜ero-Pilon˜a and Raskin  reported that the incidence of this type of diabetes among persons with new-onset diabetes with diabetic ketoacidosis was approximately 60%. In agreement with the U.S. experience, African studies have reported that 42% to 64% of patients with diabetic ketoacidosis initially treated with insulin therapy do not have classic type 1 diabetes and may experience prolonged remission. The prevalence of ketosis-prone type 2 diabetes seems to be lower in Asian and white persons and may represent fewer than 10% of cases of diabetic ketoacidosis.

Narrative Review: Ketosis-Prone Type 2 Diabetes Mellitus

The extent of the prevalence of this syndrome really isn't known. As far as I know, there is no ready test for KPD T2. What we have is hospital admittance records for DKA. The numbers quoted for Mexican and African Americans is about 60% of all the DKA cases. What this means in terms of the general Mexican and African American population is in question but you have to recognize that for every case where it is bad enough to cause hospitalization there has to be many multiples of it in existence.



  1. Hey Mike, I found you over here. This is Pauly from TU. Question. How do I use these ketone strips? Are these things accurate? I am frequently getting the middle reading on the strips. It says to call your doctor or health care team if you get a middle reading. My BG is fine though 105 or so. Is this anything to worry about. I am low carb and still working on some weight loss.
    Thanks Pauly

  2. Hi Pauly

    You've got a serious thing going with the Ketone strips don't you?

    You've got to remember that these strips were originally used as a way of seeing if blood sugars were out of control. If they were high it was assumed that there wasn't enough insulin in the body so the body was forced to burn fats.

    Low carbers use them to assure that they are in Ketosis, ie burning fats. Your glucometer gives you a far better read of your blood sugars and what's happening to you.

    You're a KPD. It is much safer for you to burn fats so unless your A1c is headed south, you're five by five.

  3. Thanks Mike for the information. Thats what I thought but I wanted to get it from someone who knows more about it than I do. I just get this stupid Atkins breath other than that I feel fine. Hope you are well. Always enjoy your posts. Take care. Pauly

  4. Ketone breath, huh? I remember reading a group of posts by low-carbers who single. The big issue what will cover ketone breath. Since, it's kinda fruity, why not try something with a fruit taste or brandy. I like brandy.

    Be well Pauly


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