Abstract
Soft drink ketosis is thought to be a subset of type 2 diabetes characterized by acute ketotic onset following excessive ingestion of soft drinks by obese people.We treated an obese 12-year-old girl hospitalized with hyperglycemia and ketosis. Although clinical features in the early course were coincidental with soft drink ketosis, she was IA-2 antibody-positive on admission, suggesting the association with autoimmune β cell destruction in the pathogenesis of her diabetes. After eventual insulin therapy, her diabetes was initially well controlled with metformin alone several months after admission. Fasting plasma glucose increased and IA-2 antibody titer increased, possibly reflecting the progression of β cell destruction, so small doses of insulin therapy were initiated. She was diagnosed with slowly progressive type 1 diabetes. Although she is non-insulin-dependent, she may show a progressive decrease in endogenous insulin secretion.
