Accuracy and Predictive Value of Classification Schemes for Ketosis-Prone Diabetes
Response to Fernández et al.
- Ashok Balasubramanyam, MD12 and
- Mario Maldonado, MD1
- 1Translational Metabolism Unit, Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, Houston, Texas
- 2Endocrine Service, Ben Taub General Hospital, Houston, Texas
- Address correspondence to Ashok Balasubramanyam, MD, Translational Metabolism Unit, Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, Room 700B, One Baylor Plaza, Houston, TX 77030. E-mail: ashokb{at}bcm.tmc.edu
Fernández et al. (1) report frequencies of ketosis-prone diabetic (KPD) patients with or without long-term β-cell function that differ markedly from ours (2) and suggest that the Aβ classification scheme is therefore inaccurate.
Ethnicity may affect the prevalence of KPD subtypes; insulin-dependent subtypes may predominate among Caucasians, as we previously reported (3) and as they also show. However, this does not mean that the Aβ scheme's accuracy in predicting long-term β-cell functional status differs across ethnic populations. Apparent differences may be due to other characteristics of the phenotypes selected for analysis. If we select within our heterogeneous cohort only patients with key characteristics similar to those …
