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Clinical study of pregnancy-associated fulminant type-1 diabetes.

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eMediNexus    29 March 2018

The purpose of a new study published in Endocrine was to devise a method for predicting pregnancy-associated fulminant type-1 diabetes (PF). This study enrolled 30 PF patients, 21 non-pregnant fulminant type-1 diabetes (NPF) patients, and 26 female patients of child-bearing age with diabetic ketoacidosis (DKA), wherein the plasma glucose (PG)/glycated hemoglobin (HbA1C) ratio was analyzed. In addition, the clinical and biochemical characteristics of the PF and NPF patients were evaluated and compared to the characteristics of the DKA patients. The findings showed that the onset of hyperglycemic symptoms, arterial PH value, serum potassium, PG, HbA1C, fasting and postprandial serum C-peptide concentration, glutamic acid decarboxylase (GAD) antibodies positivity were all significantly different among the groups. The PG/HbA1C ratio was significantly higher in PF and NPF patients than in DKA patients. Receiver-operating characteristic (ROC) curves analyses showed that PG/HbA1C ratio at a cut-off value of 3.3 resulted in the highest Youden index, with corresponding sensitivity of 93 and 100% specificity for identifying PF from DKA. Hence, it was concluded that PF patients exhibited a more severe acidosis, with higher maternal and fetal mortality rates. It was stated that PG/HbA1C ratio with a threshold of ≥3.3 can be used as a cut-off point in predicting PF from DKA in China. Furthermore, elevated PG/HbA1C ratio at the time of diagnosis is predictive for more severe insulin secretion dysfunction and poor prognosis.

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