Abstract:

Objective To explore the clinical characteristics in youth patients with atypical diabetes mellitus (ADM). Methods Medical records of 340 diabetic patients with the age of onset ≤40 years were retrospectively analyzed. Typical type 1, type 2, and other types of diabetes were excluded via medical history collection, physical examination, and laboratory examinations. A total of 20 patients met the diagnostic criteria of ADM. Their onset characteristics, changes in islet β-cell function, and indexes for glucolipid metabolism were analyzed. Results The majority of young ADM patients were male (male: female=18∶2). The percentages of patients with new-onset diabetes and a family history were high and accounted for 80.0% and 70.0%, respectively. Fasting C-peptide level and the C-peptide level 2 h after dinner in ADM patients were between those in patients with type 1 diabetes and type 2 diabetes. Besides, ADM patients had higher HbA1c and uric acid (UA) levels as compared with patients with type 2 diabetes (P=0.000, P=0.001) and higher triglyceride (TAG) level as compared with patients with type 1 diabetes (P=0.002). Nineteen patients (95.0%) stopped the insulin therapy during 6-12 months of follow-up. Among them, 12 (60.0%) were able to maintain the normal blood glucose just relying on diet and exercise. Conclusion The majority of young ADM patients are male. Most patients have new diagnosed diabetes and a family history. The lipid metabolism dysfunction is common in young ADM patients and their ability to repair islet β-cell function is favorable.

Key words: atypical diabetes mellitus, young-onset diabetes, clinical characteristics