Mechanism Underlying Beta-cell Failure in Obese African Americans With History of Hyperglycemic Crises
Status:
Completed
Trial end date:
2009-12-01
Target enrollment:
Participant gender:
Summary
Obesity is common in African American (AA) patients with newly diagnosed diabetes who present
with diabetic ketoacidosis (DKA). Despite the presentation with severe symptoms of
insulinopenia and ketoacidosis, clinical and immunogenetic observations indicate that most
obese AA patients with DKA have type 2 diabetes. In such patients, previous studies reveal
that: a) at presentation, obese AA patients with DKA have markedly decreased pancreatic
insulin secretion, lower than in obese non-DKA patients admitted with comparable
hyperglycemia, but significantly greater than in lean patients with DKA; b) aggressive
diabetic management results in significant improvement in beta-cell function and insulin
sensitivity sufficient to allow discontinuation of insulin therapy within 3 months of
follow-up. Based on these observations the researchers conclude that similar to obese
patients with hyperglycemia, most obese AA with DKA have type 2 diabetes, and that although
defects in both insulin secretion and insulin action are present, transient b-cell failure is
the primary defect in the development of ketoacidosis.