혈청 C - peptide 치로 정의한 한국인 인슐린 의존형 당뇨병 환자의 임상상

Background: Diabetes mellitus is one of the major health problems in Korea. It has been suggested that there are quite many atypical IDDM patients who initially manifest as NIDDM, but require insulin eventually. However, little is known about the clinical characteristics of this type of diabetics in Korea. This study was undertaken to find out how many current IDDM patients bad a history of noninsulin requiring phase. Methods: We obtained medical histories retrospectively from 2300 patients who visited Asan Medical Center from June 1989 to July 1992. Fifty nine patients were classified as IDDM because their fasting plasma C-peptide levels were below 0. 13fmol/L (0.4ng/ml). The patients were classified further into the two groups: group A who required isulin within 1year after diagnosis or presented as debut DKA, and group B who had nonisulin requiring phase at least for 1year after the diagnosis. Results: Twenty six patients (44%) were classified as group A, and 27patients (46%) as group B. Median age of onset was 26years in group A, (range; 10-50) and 45 (range; 23-73) in group B. As a whole, 24patients (41percent) were diagnosed as diabetes over the age of 40. Two groups had similiar values in body mass index. History of DKA was found in 58percent in group A and 7percent in group B. All patients of group A were using insulin at the time of the study, while only 56percent of group B were using insulin. Conclusion: Our study showed: first, forty percent of IDDM patients developed their diabetes at the age over 40: second, about half of the patients had a non-insulin- requiring phase at least for one year, The lack of DKA, old age of onset, and the initial non-insulin-requiring phase suggest that these patients are different from the typical IDDM. This subclass of IDDM in Korea may be classified as slowly progressive IDDM.