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The clinical and hormonal (C-peptide and glucagon) profile and liability to ketoacidosis during nutritional rehabilitation in Ethiopian patients with malnutrition-related diabetes mellitus

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dc.contributor.author J.Abdulkadir
dc.contributor.author B. Mengesha
dc.contributor.author Welde Gabriel Zewudie. Welde Gabriel
dc.contributor.author H. Keen,
dc.contributor.author Y. Worku
dc.contributor.author P.Gebre
dc.contributor.author A. Bekele
dc.contributor.author K. Urga
dc.contributor.author A. -S. Taddesse
dc.date.accessioned 2022-11-28T05:58:53Z
dc.date.available 2022-11-28T05:58:53Z
dc.date.issued 1990
dc.identifier.citation J. Abdulkadir, B. Mengesha, Z. Welde Gabriel, H. Keen, Y. Worku, P. Gebre, A. Bekele, K. Urga & A. -S. Taddesse ,The clinical and hormonal (C-peptide and glucagon) profile and liability to ketoacidosis during nutritional rehabilitation in Ethiopian patients with malnutrition-related diabetes mellitus
dc.identifier.uri http://172.21.6.100:8080/xmlui/handle/123456789/414
dc.description.abstract Cases of malnutrition-related diabetes mellitus conforming to the description of the protein deficient pancreatic diabetes type in Ethiopian patients were compared with Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetic. Fourteen of 39 malnutriton-related diabetes mellitus patients had fat malabsorption compared with only two of ten Type 1 diabetic patients and one of nine control subjects. Xylose absorption was normal favouring a pancreatic cause for the malabsorption. Plasma C-peptide during oral glucose tolerance test was significantly lower than that in Type 2 diabetic patients and normal control subjects (p<0.01 to 0.001) and was also consistently but not significantly higher than in Type 1 diabetic patients. Glucagon secretion patterns were similar in malnutriton-related and Type 1 diabetic patients. Of 23 new malnutrition-related diabetic patients treated with glibenclamide after nutritional rehabilitation and insulin treatment, only three responded, 14 were unresponsive but remained ketosis free for over eight days while another six developed ketoacidosis or significant ketonuria within two to six days during the trial. Sixteen unselected Type 1 diabetic patients who discontinued their insulin therapy all developed frank ketoacidosis after a mean of 5.5 days. The similarity of the malnutrition-related and Type 1 diabetes mellitus in age of onset, insulin requirement for diabetic control and appearance of ketosis-proneness in some cases, together with the similarity of C-peptide and glucagon secretion patterns suggest that the protein deficient pancreatic diabetes variant of malnutrition-related diabetes mellitus may be Type 1 diabetes mellitus modified by the background of malnutrition rather than an aetiologically separate entity. Community based studies are required to ascertain frequency and types of diabetes mellitus in malnourished populations and the role of genetics and environment in their aetiology.
dc.format.extent 222-227
dc.subject NUTRITIONAL REHABILITATION
dc.subject KETOSIS-RESISTANCE
dc.subject FAT MALABSORPTION
dc.subject C-PEPTIDE
dc.subject GLUCAGON
dc.title The clinical and hormonal (C-peptide and glucagon) profile and liability to ketoacidosis during nutritional rehabilitation in Ethiopian patients with malnutrition-related diabetes mellitus
dc.type Journal Article
ep.identifier.status Open Access
ep.identifier.status Open Access
ep.identifier.doi https://doi.org/10.1007/bf00404800
ep.journal Diabetologia
ep.issue 1
ep.volume 33


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