ketosis prone diabetes; flatbush diabetes, type 1B diabetes, atypical diabetes

Pathology

• episodic diabetic ketoacidosis resulting from insulin deficiency
• variable periods of insulin dependence & independence
• islet beta-cells impaired by glucose toxicity

Laboratory

• C-peptide in serum weeks to months after episode of diabetic ketoacidosis
  • islet beta-cell function confirmed by C-peptide in serum > 1 ng/mL
  • serum C-peptide is a marker for endogenous insulin production & residual beta-cell function
    • useful for determining whether patients with ketosis-prone diabetes require insulin
• glutamic acid decarboxylase Ab in serum to evaluate for type 1 diabetes

Management

• treatment of diabetic ketoacidosis (DKA)
• if islet beta-cell function confirmed & type 1 diabetes unlikely, insulin may be discontinued & metformin started

More general terms

• diabetes mellitus