Ketosis-Prone Type 2 Diabetes Mellitus In Children And Adolescents

A subset of adolescents with T2DM appears to be at increased risk for development of Diabetic ketoacidosis (DKA) at the time of diagnosis. The highest prevalence of DKA at onset is observed in African-American adolescents, reaching up to 25%. DKA at onset of T2DM in youth has also been described in Japan, Thailand, and Canada. Adolescents with T2DM presenting with DKA are extremely obese, with markedly elevated HbA1c levels at presentation. Known precipitants for the episode of DKA are severe infections and exposure to atypical antipsychotic drugs, however, most often no specific etiology is identified. Acute complications, such as cerebral edema, have been described in adolescent with T2DM. The discrimination between T1DM and T2DM in an individual with new onset diabetes presenting with DKA is extremely difficult on clinical grounds alone.