1) Objective:
@EN To clarify the clinical characteristics and serum C-peptide levels of insulin dependent diabetes mellitus(IDDM) and non-insulin dependent diabetes mellitus(NIDDM).
@ES 2) Methods and Materials :
@EN 19 IDDM and 68 NIDDM(48 insulin requiring and 20 non insulin requiring NIDDM), of whom serum C-peptide levels were measured, were included, Patients were classified as typical IDDM in the presence of the following criteria: 1) body mass
index(BMI)
less than 25kg/m*, 2) positive serum or urine ketone bodies, 3) insulin treatment started within one year after diagnosis. Various clinical parameters including glucagon-stimulated serum C-peptide levels were compared among the clinical class of
diabetic patients.
@ES Results:
@EN In IDDM patients, onset age was younger than that of NIDDM(29± vs. 51±2 years, p<0.01), and histories of weight loss(74%) and ketosis-proneness(74%) were more prevalent than those of NIDDM(25%, p<0.05, p<0.01). BMI(18.9±0.8,
23.3±0.4kg/m*,
p<0.01). Waist to hip girth ratio(WHR) (0.82±0.03. 0.93±0.01cm/cm, p<0.01), fasting serum C-peptide levels(0.7±0.2, 1.3±0.1ng/mL, p<0.05), and glucagon-stimulated serum C-peptide levels(0.9±0.2, 2.7±0.3ng/mL, p<0.01) were lower in IDDM
patients.
HbA1c levels were higher in IDDM(11.3±0.7, 9.6±0.3%, p<0.05) than those of NIDDM patients.
In NIDDM patients group, durations of diabetes were longer in insulin requiring group than those of non insulin requiring group(8±1, 4±2 years, p<0.05). Other clinical parameters were not different between these two groups.
Onset age, history of weight loss, history of ketosis-proneness, BMI WHR, and HbA1c level were different between insulin requiring patients including IDDM and NIDDM and non insulin requiring NIDDM patients. Differences of fasting serum C-peptide
levels
were observed between IDDM and non insulin requiring NIDDM as well as between insulin requiring NIDDM and non insulin requiring NIDDM patients. Stimulated serum C-peptide levels were different between all of those groups.
Correlation coefficients between fasting and stimulated serum C-peptide levels were 0.54(p<0.05) in IDDM, 0.85(p<0.01) in NIDDM patients, respectively. In IDDM patients, serum triglyceride levels were correlated with fasting serum C-peptide
levels(r=0.49, p<0.05). Postprandial serum glucose levels showed negative correlation with stimulated serum C-peptide levels (r=-0.43, p<0.05). In NIDDM patients, BMI and fasting C-peptide, BMI and stimulated C-peptide levels, fasting serum
glucose
and
fasting C-peptide levels showed significant correlation. On the other hand, HbA1c levels showed negative correlation with serum C-peptide levels. Fasting serum glucose levels were positively(r=0.36, p<0.01) and serum HDL-cholesterol levels were
negatively(r=-0.27, p<0.05) correlated with fasting serum C-peptide levels in insulin requiring NIDDM patients. In non insulin requiring NIDDM patients, BMI were correlated with fasting and stimulated C-peptide levels(r=0.71, p<0.01, r=0.69,
p<0.01),
and HbA1c levels were negatively correlated with fasting and stimulated serum C-peptide levels(r=-0.51, p<0.05, r=-0.44, p<0.05), respectively.
@ES 4) Conclusion:
@EN In Korean adult-onset diabetic patients, no single clinical parameter is decisive to classify the clinical diabetes mellitus because of the heterogeneity and atypical clinical course of the disese. To make the clinical characterisitos of
Korean
adult-onset diabetic patients clear, a large-scale, prospective study targeting recent-onset diabetes is needed.
|