Mauvais-Jarvis et al evaluated ketosis-prone patients with nonautoimmune Type 2 diabetes mellitus. The authors are from Saint Louis Hospital (Paris), the University of Paris VII, San Francilien Hospital, Lariboisiere Hospital and the University of California San Francisco.


Risk factors for being ketosis prone:

(1) non-Caucasian race

(2) male

(3) family history

(4) high body mass index (BMI)


These patients tend to be middle-aged.


A patient may or may not be insulin dependent. A non-insulin dependent patient may go for months or years in normoglycemia, only to have a ketotic episode. As time goes on more patients eventually become insulin dependent (10% insulin dependent after 3 years, 60% dependent after 10 years).


A ketotic episode in a non-insulin dependent patient may be preceded by:

(1) increasing percent of glycated hemoglobin (as a sign of progressive hyperglycemia), which may be seen several months before a relapse

(2) sudden unintended weight loss


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