DIABETIC-KETOACIDOSIS AMONG OBESE AFRICAN-AMERICAN ADOLESCENTS WITH NIDDM

OBJECTIVE - To determine whether ketosis at the time of presentation o ccurs among African-American adolescents with NIDDM. RESEARCH DESIGN A ND METHODS - We reviewed the charts of all islet cell antibody (ICA) n egative patients diagnosed with NIDDM at Children's Hospital Medical C enter (CHMC) between 1982 and 1995. RESULTS - Between 1982 and 1985, 7 0 adolescents were diagnosed with NIDDM. Of these, ICA determinations were available and negative on 42 subjects (28 African-American, 12 wh ite). Twelve of 28 (42%) African-American patients presented with keto nuria, and seven of 28 (25%) presented with DKA. In comparison, none o f 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 betwee n the age, BMI, or sex distribution of patients with and without ketos is. Previously diagnosed hypertension was present in 42% of patients p resenting with ketosis, compared with 17% of the general NIDDM populat ion at CHMC. CONCLUSIONS - We conclude that ketosis may occur among Af rican-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 nece ssarily imply the presence of IDDM and insulin dependence.