Young Chinese adults with new onset of diabetic ketoacidosis - clinical course, autoimmune status and progression of pancreatic β-cell function

Aims To examine the clinical course, autoimmune status and pancreatic β cell function, over a 2‐year period, in young Chinese subjects newly presenting with diabetic ketoacidosis (DKA). Methods A prospective study involving 562 out of 27 893 patients who were admitted to the medical ward with a principal diagnosis of diabetes mellitus during the recruitment period of 1 year. Results Of these 562 patients, 27 were aged less than 35 years and admitted with a diagnosis of DKA and 11 (six males and five females) of these were newly diagnosed. Antibodies to glutamic acid decarboxylase (GAD) were present in five patients. Anti‐ICA 512 was not detected in any of the patients. Basal and post‐glucagon stimulated plasma C‐peptide remained in the insulin‐deficient range although showing improvement at 2 years. Conclusions These findings confirm the relative rarity of autoimmune Type 1 diabetes in young Chinese. Even when the clinical presentation takes the extreme form of acute DKA, less than 50% have positive autoimmune markers.