Abstract
The patient was an obese 44-year-old man. He developed symptoms of hyperglycemia in July 2008 and was admitted to the hospital with a diagnosis of diabetic ketosis on July 25th. He did not consume a lot of soft drinks. Tests for the anti-GAD antibody were negative. He was gradually weaned from insulin, and discharged on oral pioglitazone. Although the HbA1c level improved to 5.6 %, subsequent weight gain led to poor glycemic control in July 2009. He was hospitalized with hyperglycemia symptoms in August 2009. The HbA1c level was 8.5 %. His urine was positive for ketone bodies. His endogenous insulin secretory function had declined from the previous year. His serum was positive for islet-associated autoantibodies. Despite an improvement with insulin therapy, glycemic control deteriorated again because the patient was not able to comply with the diet and exercise therapy, thus resulting in weight gain. The endogenous insulin secretory function showed a slight, but insufficient improvement after his discharge from the hospital. Islet-associated autoantibodies became negative in April 2011. The patient was therefore diagnosed to have ketosis-prone type 2 diabetes, based on the clinical course. There have so far been few reports of this condition in Japan. This report presents this case, along with a review of the pertinent literature.
