BACKGROUND: Some adult, @entity28 and @entity6 @entity1 , initiate their disease with a severe @entity6 without a precipitating factor and do not require insulin thereafter. These @entity1 are classified as having a "non classical" @entity6 . AIM: To study the clinical, immunological, genetic and metabolic features of @entity1 with non classical @entity6 . @entity1 AND METHODS: Ten @entity1 (9 @entity1 , aged 45 +/- 12 years old) with non classical @entity6 were studied. Anti islet and anti @entity367 decarboxylase antibodies (ICA and anti GAD), HLA DQ alpha @entity369 52 and non aspartic beta 57 were measured. Insulin secretion was measured by C peptide after glucagon injection and with the minimal model of Bergman. The latter model was also used to determine insulin sensitivity. RESULTS: Three @entity1 were immunologically classified as type 1, since they had positive ICA or antiGAD antibodies and type 1 genetics (neutral or susceptible HLA DQ alpha and beta). They had insulin secretion after glucagon stimulus (C peptide ranging from 2.2 to 7.5 pmol/ml), but an almost absent response to a @entity413 load. They were also insulin resistant (a sensitivity index ranging from 0.05 to 1.67 x 10(-4) min/microU x ml). These three cases could be categorized as latent type 1. The other seven @entity1 were ICA negative and antiGAD negative. Five had a susceptible HLA genotype for type 1 @entity6 and two were neutral. All had insulin secretion after glucagon stimulation and a variable response to @entity413 . Six were insulin resistant (sensitivity index ranging from 0.32 to 1.29 x 10(-4) min/microU x ml). One @entity1 was insulin sensitive (sensitivity index of 3.83 x 10(-4) min/microU x ml). Therefore all these @entity1 were classified as type two diabetics with an atypical debut. CONCLUSIONS: Not all diabetics presenting with a severe @entity6 are type I. Among these, there are subjects with a latent type 1 @entity6 or with an @entity2175 .

[Non classical subtypes of XXXX ].

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS', 'men'] @entity2175 :: ('MESH:D003924', 'Disease') :: ['atypical type 2 diabetes'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic ketoacidosis', 'diabetic', 'diabetes', 'diabetes mellitus'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obese'] @entity367 :: ('CHEBI:18237', 'Chemical') :: ['glutamic acid'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity369 :: ('CHEBI:29016', 'Chemical') :: ['arginine']
@entity6 :: (MESH:D003920,Disease) :: ['diabetes mellitus']
