Ketosis-prone Diabetes and Hypogonadism: A New Clinical Association to be Aware of ?

糖尿病 联想(心理学) 医学 酮症 内科学 内分泌学 心理学 心理治疗师
作者
Andrea Graziani,Riccardo Maria Pollis,Benedetta Maria Bonora,Carla Scaroni,Chiara Sabbadin
出处
期刊:Endocrine, metabolic & immune disorders [Bentham Science Publishers]
卷期号:23 (12): 1552-1556 被引量:2
标识
DOI:10.2174/1871530323666230621114503
摘要

Background: Ketosis-prone diabetes (KPD) is an emerging entity, sharing features of both type 1 diabetes mellitus and type 2 diabetes mellitus. Patients with KPD usually present with diabetic ketoacidosis without the classic phenotype of autoimmune type 1 diabetes. In most cases, they are Afro-American adults, who require insulin therapy for the management of acute decompensation, then usually encountering insulin-free remission for prolonged periods of time with diet or with non-insulin agents. Meanwhile, hypogonadism is a known condition that could be associated with higher risk of developing both type 1 and type 2 diabetes and could be a risk factor for decompensated diabetes. The association of KPD and hypogonadism is reported for the first time in literature. Case Presentation: Here we report two peculiar cases of young African patients, affected by KPD and hypergonadotropic hypogonadism, respectively Klinefelter’s syndrome and primary ovarian failure. Both patients were treated promptly for the ketoacidosis with intravenous fluids combined with con-tinuous insulin infusion, and then switched to subcutaneous regimen. After the correct clinical evalu-ation, oral antidiabetic drugs were added. Conclusion: KPD remains an under-recognized and under-diagnosed type of diabetes. As hypogonad-ism is strongly linked to dysmetabolic disorders, the evaluation of sex hormones should be performed at the onset of diabetes. Further studies should investigate the hypothalamic-pituitary-gonadal axis and its role in the development of KDP and its manifestations and complications.
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