한국인 성인 당뇨병의 병인론적 이형성 = The Etiologic Heterogeneity of Diabetes Mellitus in Korean Adults한국인 성인 당뇨병의 병인론적 이형성

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

One hundred and twenty-one Korean adult diabetic patients with recent onset, diagnosed between the ages of 30 and 77 years, were investigated for the parameters of glycemic control, islet cell function, and immunologic markers of insulitis. The antibody tests were compared to the results of the 40 nondiabetic controls matched for age and body mass index (BMI). The 12 (9.9%) diabetic subjects were found to have positive islet cell surface antibody (ICSA). These patients were characterized by a small basal insulin reserve, more ketonuria, and poor glycemic control, although the maleness, the age at onset, and the duration of diabetes were the same as in 109 ICSA-negative cases. However, 11 patients (10.2%) having insulin autoantibody (IA) presented less basal and stimulated C-peptide reactivities, while other parameters compared were not different from those of IA-negative patients. Twelve patients were treated with insulin during follow-up for better glycemic control. Insulin-treated patients included those with poor glycemic control, more ketonuria, more proteinuria, longer duration of diabetes, and lower basal and stimulated C-peptide level, while the age of onset, the amount of weight loss, and the duration of diabetes were the same as in 87 cases treated without insulin. From these observations, it is suggested that 1) a significant number of Korean adult diabetic patients, who have not been treated with insulin initially, require insulin to control their high blood glucose levels: 2) about 17% of the middle-aged diabetic patients, who were diagnosed after the age of 30 are autoantibody positive suggesting autoimmune in etiology: 3) low C-peptide response after glucagon stimulation may be useful in predicting insulin deficiency when combined with ICSA and IA.