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.

Showing posts with label Japanese. Show all posts
Showing posts with label Japanese. Show all posts

Monday, February 11, 2013

Ethnic minorities in the U.S. have nearly twice the risk of diabetes even with low BMI's



This came across my desk from Medscape. http://www.medscape.com/viewarticle/779072?src=nl_topic

Recently, the Excellence in Diabetes 2013 conference was held in Turkey. One of the big statements to come out of it was this: “ type 2 diabetes, usually associated with obesity, can occur in many seemingly thin people from ethnic minorities.”
 
"Diabetes risk is higher in all ethnic groups than in whites, and of course some of this is just due to body weight, but evidence is now building that people of many races may be at increased risk of diabetes and cancer before they are even considered conventionally overweight."

Meanwhile, Chittaranjan Yajnick, MD, from King Edward Memorial Diabetes Unit, Pune, India, also gave a talk on what makes Indians so susceptible to diabetes. "We have seen that Indians are often diagnosed with diabetes 10 years earlier and 5- to 10-units BMI thinner than whites," he noted.
Both believe the explanation lies in "hidden" visceral fat found inside the body, between organs, in Asians and probably other ethnic groups too, but not in whites. This in turn affects the levels of adipokines secreted, such as leptin and adiponectin, which can have adverse metabolic effects.
The knowledge that Asians and other ethnic groups are at much greater risk for diseases associated with obesity, such as diabetes and many cancers, than whites, is not new, Dr. Maskarinec explained. But more recently, researchers have begun to show that nonwhites who are not even particularly overweight or who are of "normal" weight are at much higher risk than whites.

"People have talked about some kind of adaptation for white people, who have had a greater number of years to adjust to the type of food we are eating now," she postulated.

What they aren’t saying is that the connection between weight gain and diabetes isn’t as tight as they thought. Most of all prescriptions for holding off diabetes suggest that the key is healthy eating and exercise. This, I think, is largely due to how Americans view being overweight, which is strongly associated with diabetes in this country. People become fat because they over eat and don’t exercise. It is the same old “gluttony and  sloth“ line.

This attitude has pervaded the science as well. The first suggestion is that thin diabetics are secret fat people. Their fat is hidden because of its visceral nature.  So the relationship still holds even if only by the slimmest of margins.

There is one thing which does, however, come through loud and clear.

Ethnic minorities that come to the U.S. and take up the standard American diet are at a very high risk of diabetes. There is something toxic in our food/environment that isn’t as widespread in the rest of world. It is becoming so though as we see in the rising rates of diabetes around the world.

People here who aren’t part of ethnic minorities tend to discount problem but they should view this as a “canary in a coal mine” situation. On some level, this is affecting everyone. We really need to quit looking at fat and start looking at what in our environment forces our bodies to put on fat.

Thursday, April 7, 2011

Who gets KPD T2? Everybody!

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


Thai
Indian


Peruvian




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.http://www.ncbi.nlm.nih.gov/pubmed/19477546

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 Diabeteshttp://care.diabetesjournals.org/content/26/9/2697.1.full

[HETEROGENEITY OF TYPE 1 DIABETES MELLITUS] - Brazilian
http://www.ncbi.nlm.nih.gov.proxy1.cl.msu.edu/pubmed/18438531
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
http://www.acadjourn.org/IJMMS/abstracts/abstracts/abstracts2009/Sept/Khan%20and%20%20Akram.htm


Ketoacidosis in Apache Indians with non-insulin-dependent diabetes mellitus
http://www.ncbi.nlm.nih.gov/pubmed/9382666


Cetoacidosis diabética:una complicación frecuente de la diabetes tipo 2 en hispanoamericanos
http://www.sediabetes.org/resources/revista/00011519archivoarticulo.pdf


The Occurrence of Diabetic Ketoacidosis in Type 2 Diabetic Chinese Adults
http://www.tsim.org.tw/journal/jour10-6/P10_230.PDF


Characteristics of Caucasian type 2 diabetic patients during ketoacidosis and at follow-up
http://www.ncbi.nlm.nih.gov/pubmed/10842773


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
http://www.annals.org/content/144/5/350.abstract

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.





Mike