Modeling Ketosis-Prone Diabetes Remission Via Diverse Mechanisms of Glucotoxicity
Emory University
Summary
The goal of this study is to quantify day-to-day changes in blood glucose during treatment towards remission in ketosis-prone diabetes (KPDM) and describe them using a mathematical model of KPDM pathogenesis and remission.
Description
Approximately half of newly diagnosed obese African Americans presenting with diabetic ketoacidosis (DKA) have clinical, metabolic and immunologic features of type 2 diabetes (T2D), also known as ketosis-prone diabetes (KPDM). Unlike patients with type 1 diabetes, with intensive insulin treatment, approximately 70% of patients with KPDM exhibit improved pancreatic β-cell function and insulin sensitivity to allow discontinuation of insulin therapy (indicating near-normoglycemia remission based on fasting blood glucose (FBG) \< 130 mg/dl and HbA1c \< 7% off insulin therapy during follow-up\]). T…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Provide informed consent * Have a BMI ≥ 28 kg/m2 * Be of African American ancestry * Meet diagnostic criteria for DKA. Diagnostic criteria for DKA will include a plasma glucose \> 250 mg/dl, a venous pH \< 7.30, a serum bicarbonate \< 18 mmol/l, and serum ketones (beta-hydroxy butyrate) \> 1.5 mmol/L. Exclusion Criteria: * Significant medical or surgical illness including but not limited to myocardial ischemia, congestive heart failure, chronic peripheral venous insufficiency, chronic renal insufficiency, liver insufficiency (serum transaminases 3 times the upper limit…
Interventions
- DeviceContinuous Glucose Monitoring
After insulin discontinuation participants continue wearing their CGMs, for a total of 3 months.
- DrugInsulin
Participants will receive standard-of-care insulin treatment. Insulin dosing will be adjusted based on CGM glucose readings.
Locations (2)
- Grady Health SystemAtlanta, Georgia
- Emory University Hospital MidtownAtlanta, Georgia