KETOACIDOSIS-ONSET NONINSULIN-DEPENDENT DIABETES IN JAPANESE SUBJECTS

In 5 patients (2 women and 3 men, aged 16-36 years), diabetic ketoacid osis developed without precipitating illness. Pancreatic islet cell an tibody was negative, and the duration of insulin dependency was shorte r than 4 weeks. Hemoglobin A(1c) was less than or equal to 6.3% for th e mean period of 2.8 years thereafter, with diet therapy alone in 4 an d with 5 mg glyburide in 1. Four were overweight before the developmen t of diabetes, and 3 of them positive for family history of adult-onse t, non-ketotic diabetes. Frequency of human leukocyte antigen B61 was increased significantly in the patients. In a patient not previously o verweight, family history of diabetes was negative, and human leukocyt e antigen haplotypes common in insulin-dependent diabetes mellitus wer e accumulated. Serum immunoreactive insulin was within normal range or supranormal with normal glucose tolerance after recovery. The patient s closely resemble black. Americans with ketoacidosis-onset non-insuli n dependent diabetes.