Diabetic Ketoacidosis Among Obese African-American Adolescents With NIDDM

  1. Philip S Zeitler, MD, PHD
  1. Division of Endocrinology, Department of Pediatrics Ramat-Hasharon, Israel
  2. Children's Hospital Research Foundation and the University of Cincinnati College of Medicine Cincinnati, Ohio; and Maccabi Pediatric Endocrine Unit Ramat-Hasharon, Israel
  1. Address correspondence and reprint requests to Philip S. Zeitler, MD, PhD, Division of Endocrinology, The Children's Hospital, 1056 East 19th Ave., Denver, CO 80218-1088. E-mail: zeitlerp{at}jove.uchsc.edu

Abstract

OBJECTIVE To determine whether ketosis at the time of presentation occurs among African-American adolescents with NIDDM.

RESEARCH DESIGN AND METHODS We reviewed the charts of all islet cell antibody (ICA) negative patients diagnosed with NIDDM at Children's Hospital Medical Center (CHMC) between 1982 and 1995.

RESULTS Between 1982 and 1985, 70 adolescents were diagnosed with NIDDM. Of these, ICA determinations were available and negative on 42 subjects (28 African-American, 12 white). Twelve of 28 (42%) African-American patients presented with ketonuria, and seven of 28 (25%) presented with DKA. In comparison, none of the 12 white adolescents with NIDDM had ketonuria at presentation or during their subsequent course. Mean follow-up time for patients with ketosis at presentation was 24 months. There was no difference between the age, BMI, or sex distribution of patients with and without ketosis. Previously diagnosed hypertension was present in 42% of patients presenting with ketosis, compared with 17% of the general NIDDM population at CHMC.

CONCLUSIONS We conclude that ketosis may occur among African-American adolescents with NIDDM, as has been previously reported among African-American adults with NIDDM. Therefore, ketosis in obese young African-American patients with new-onset diabetes does not necessarily imply the presence of IDDM and insulin dependence.

  • Received September 5, 1996.
  • Accepted November 11, 1996.
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