Idiopathic type 1 diabetes in dallas, Texas: A 5-year experience

Antonio Piñero-Piloña, Patrick Litonjua, Larissa Aviles-Santa, Philip Raskin

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

OBJECTIVE -To describe the clinical course of individuals with idiopathic type 1 diabetes after a mean of 5 years from diagnosis and to compare glycemic control between those treated with diet and/or oral agents and those treated with insulin at follow-up. RESEARCH DESIGN AND METHODS- Medical records of patients with new-onset diabetes, who presented with unprovoked diabetic ketoacidosis, were reviewed. A total of 54 of these individuals were traceable and had relevant data collected within the past 2 years. All patients had nonsusceptibility HLA haplotypes and no serological evidence of autoimmune type 1 diabetes. Most of these patients were male (41 men and 13 women), were non-Caucasian, were obese at the time of diagnosis (BMI 31.6 ±6.3 kg/m2), reported weight loss (12.8 ±9.8 kg), had a family history of type 2 diabetes, and had acanthosis nigricans. At follow-up, 33 patients were still taking insulin and 21 were on diet and/or oral-agent therapy. RESULTS -Both treatment groups were similar in clinical presentation and demographics at diagnosis. After 4.8 ±1.6 years of follow-up, the 33 patients that were receiving insulin had a lower HbA1c than the 21 patients who were using therapies other than insulin (7.8 ±2.4 vs. 11.1 ±3.5%, P = 0.009; 95% CI 1.0-6.5%). There was a high correlation between change in weight and change in HbA1c at follow-up (r = 0.45, P < 0.001, n = 54). There were no differences in the rate of diabetes complications or in the episodes of recurrent diabetic ketoacidosis. CONCLUSIONS- Idiopathic type 1 diabetes occurs more frequently in male African-American patients but also occurs in other ethnic groups. Patients with idiopathic type 1 diabetes who continued to use insulin had better glycemic control than patients using therapies other than insulin. Regained weight is a good clinical marker for improvement in glycemic control. Individuals with this type of diabetes should not be switched to therapies other than insulin.

Original languageEnglish (US)
Pages (from-to)1014-1018
Number of pages5
JournalDiabetes Care
Volume24
Issue number6
StatePublished - 2001

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Type 1 Diabetes Mellitus
Insulin
Diabetic Ketoacidosis
Acanthosis Nigricans
Diet
Therapeutics
Weights and Measures
Diabetes Complications
Ethnic Groups
African Americans
Type 2 Diabetes Mellitus
Haplotypes
Medical Records
Weight Loss
Research Design
Biomarkers
Demography

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Piñero-Piloña, A., Litonjua, P., Aviles-Santa, L., & Raskin, P. (2001). Idiopathic type 1 diabetes in dallas, Texas: A 5-year experience. Diabetes Care, 24(6), 1014-1018.

Idiopathic type 1 diabetes in dallas, Texas : A 5-year experience. / Piñero-Piloña, Antonio; Litonjua, Patrick; Aviles-Santa, Larissa; Raskin, Philip.

In: Diabetes Care, Vol. 24, No. 6, 2001, p. 1014-1018.

Research output: Contribution to journalArticle

Piñero-Piloña, A, Litonjua, P, Aviles-Santa, L & Raskin, P 2001, 'Idiopathic type 1 diabetes in dallas, Texas: A 5-year experience', Diabetes Care, vol. 24, no. 6, pp. 1014-1018.
Piñero-Piloña A, Litonjua P, Aviles-Santa L, Raskin P. Idiopathic type 1 diabetes in dallas, Texas: A 5-year experience. Diabetes Care. 2001;24(6):1014-1018.
Piñero-Piloña, Antonio ; Litonjua, Patrick ; Aviles-Santa, Larissa ; Raskin, Philip. / Idiopathic type 1 diabetes in dallas, Texas : A 5-year experience. In: Diabetes Care. 2001 ; Vol. 24, No. 6. pp. 1014-1018.
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abstract = "OBJECTIVE -To describe the clinical course of individuals with idiopathic type 1 diabetes after a mean of 5 years from diagnosis and to compare glycemic control between those treated with diet and/or oral agents and those treated with insulin at follow-up. RESEARCH DESIGN AND METHODS- Medical records of patients with new-onset diabetes, who presented with unprovoked diabetic ketoacidosis, were reviewed. A total of 54 of these individuals were traceable and had relevant data collected within the past 2 years. All patients had nonsusceptibility HLA haplotypes and no serological evidence of autoimmune type 1 diabetes. Most of these patients were male (41 men and 13 women), were non-Caucasian, were obese at the time of diagnosis (BMI 31.6 ±6.3 kg/m2), reported weight loss (12.8 ±9.8 kg), had a family history of type 2 diabetes, and had acanthosis nigricans. At follow-up, 33 patients were still taking insulin and 21 were on diet and/or oral-agent therapy. RESULTS -Both treatment groups were similar in clinical presentation and demographics at diagnosis. After 4.8 ±1.6 years of follow-up, the 33 patients that were receiving insulin had a lower HbA1c than the 21 patients who were using therapies other than insulin (7.8 ±2.4 vs. 11.1 ±3.5{\%}, P = 0.009; 95{\%} CI 1.0-6.5{\%}). There was a high correlation between change in weight and change in HbA1c at follow-up (r = 0.45, P < 0.001, n = 54). There were no differences in the rate of diabetes complications or in the episodes of recurrent diabetic ketoacidosis. CONCLUSIONS- Idiopathic type 1 diabetes occurs more frequently in male African-American patients but also occurs in other ethnic groups. Patients with idiopathic type 1 diabetes who continued to use insulin had better glycemic control than patients using therapies other than insulin. Regained weight is a good clinical marker for improvement in glycemic control. Individuals with this type of diabetes should not be switched to therapies other than insulin.",
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N2 - OBJECTIVE -To describe the clinical course of individuals with idiopathic type 1 diabetes after a mean of 5 years from diagnosis and to compare glycemic control between those treated with diet and/or oral agents and those treated with insulin at follow-up. RESEARCH DESIGN AND METHODS- Medical records of patients with new-onset diabetes, who presented with unprovoked diabetic ketoacidosis, were reviewed. A total of 54 of these individuals were traceable and had relevant data collected within the past 2 years. All patients had nonsusceptibility HLA haplotypes and no serological evidence of autoimmune type 1 diabetes. Most of these patients were male (41 men and 13 women), were non-Caucasian, were obese at the time of diagnosis (BMI 31.6 ±6.3 kg/m2), reported weight loss (12.8 ±9.8 kg), had a family history of type 2 diabetes, and had acanthosis nigricans. At follow-up, 33 patients were still taking insulin and 21 were on diet and/or oral-agent therapy. RESULTS -Both treatment groups were similar in clinical presentation and demographics at diagnosis. After 4.8 ±1.6 years of follow-up, the 33 patients that were receiving insulin had a lower HbA1c than the 21 patients who were using therapies other than insulin (7.8 ±2.4 vs. 11.1 ±3.5%, P = 0.009; 95% CI 1.0-6.5%). There was a high correlation between change in weight and change in HbA1c at follow-up (r = 0.45, P < 0.001, n = 54). There were no differences in the rate of diabetes complications or in the episodes of recurrent diabetic ketoacidosis. CONCLUSIONS- Idiopathic type 1 diabetes occurs more frequently in male African-American patients but also occurs in other ethnic groups. Patients with idiopathic type 1 diabetes who continued to use insulin had better glycemic control than patients using therapies other than insulin. Regained weight is a good clinical marker for improvement in glycemic control. Individuals with this type of diabetes should not be switched to therapies other than insulin.

AB - OBJECTIVE -To describe the clinical course of individuals with idiopathic type 1 diabetes after a mean of 5 years from diagnosis and to compare glycemic control between those treated with diet and/or oral agents and those treated with insulin at follow-up. RESEARCH DESIGN AND METHODS- Medical records of patients with new-onset diabetes, who presented with unprovoked diabetic ketoacidosis, were reviewed. A total of 54 of these individuals were traceable and had relevant data collected within the past 2 years. All patients had nonsusceptibility HLA haplotypes and no serological evidence of autoimmune type 1 diabetes. Most of these patients were male (41 men and 13 women), were non-Caucasian, were obese at the time of diagnosis (BMI 31.6 ±6.3 kg/m2), reported weight loss (12.8 ±9.8 kg), had a family history of type 2 diabetes, and had acanthosis nigricans. At follow-up, 33 patients were still taking insulin and 21 were on diet and/or oral-agent therapy. RESULTS -Both treatment groups were similar in clinical presentation and demographics at diagnosis. After 4.8 ±1.6 years of follow-up, the 33 patients that were receiving insulin had a lower HbA1c than the 21 patients who were using therapies other than insulin (7.8 ±2.4 vs. 11.1 ±3.5%, P = 0.009; 95% CI 1.0-6.5%). There was a high correlation between change in weight and change in HbA1c at follow-up (r = 0.45, P < 0.001, n = 54). There were no differences in the rate of diabetes complications or in the episodes of recurrent diabetic ketoacidosis. CONCLUSIONS- Idiopathic type 1 diabetes occurs more frequently in male African-American patients but also occurs in other ethnic groups. Patients with idiopathic type 1 diabetes who continued to use insulin had better glycemic control than patients using therapies other than insulin. Regained weight is a good clinical marker for improvement in glycemic control. Individuals with this type of diabetes should not be switched to therapies other than insulin.

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