A mathematical model for ketosis-prone diabetes suggests the existence of multiple pancreatic β-cell inactivation mechanisms

Ketosis-prone diabetes mellitus (KPD) is a subtype of type 2 diabetes, which presents much like type 1 diabetes, with dramatic hyperglycemia and ketoacidosis. Although KPD patients are initially insulin-dependent, after a few months of insulin treatment, roughly 70% undergo near-normoglycemia remiss...

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Main Authors: Sean A Ridout, Priyathama Vellanki, Ilya Nemenman
Format: Article
Language:English
Published: eLife Sciences Publications Ltd 2025-07-01
Series:eLife
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Online Access:https://elifesciences.org/articles/100193
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author Sean A Ridout
Priyathama Vellanki
Ilya Nemenman
author_facet Sean A Ridout
Priyathama Vellanki
Ilya Nemenman
author_sort Sean A Ridout
collection DOAJ
description Ketosis-prone diabetes mellitus (KPD) is a subtype of type 2 diabetes, which presents much like type 1 diabetes, with dramatic hyperglycemia and ketoacidosis. Although KPD patients are initially insulin-dependent, after a few months of insulin treatment, roughly 70% undergo near-normoglycemia remission and can maintain blood glucose without insulin, as in early type 2 diabetes or prediabetes. Here, we propose that these phenomena can be explained by the existence of a fast, reversible glucotoxicity process, which may exist in all people but be more pronounced in those susceptible to KPD. We develop a simple mathematical model of the pathogenesis of KPD, which incorporates this assumption, and show that it reproduces the phenomenology of KPD, including variations in the ability for patients to achieve and sustain remission. These results suggest that a variation of our model may be able to quantitatively describe variations in the course of remission among individuals with KPD.
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spelling doaj-art-8d397b2c1d3c4ce0a919833414de72302025-08-20T03:25:23ZengeLife Sciences Publications LtdeLife2050-084X2025-07-011310.7554/eLife.100193A mathematical model for ketosis-prone diabetes suggests the existence of multiple pancreatic β-cell inactivation mechanismsSean A Ridout0https://orcid.org/0000-0003-2387-8361Priyathama Vellanki1https://orcid.org/0000-0002-6544-015XIlya Nemenman2https://orcid.org/0000-0003-3024-4244Department of Physics, Emory University, Atlanta, United States; Initiative in Theory and Modeling of Living Systems, Emory University, Atlanta, United StatesDepartment of Internal Medicine, Division of Endocrinology, Emory University School of Medicine, Emory University, Atlanta, United States; Grady Health System, Atlanta, United StatesDepartment of Physics, Emory University, Atlanta, United States; Initiative in Theory and Modeling of Living Systems, Emory University, Atlanta, United States; Department of Biology, Emory University, Atlanta, United StatesKetosis-prone diabetes mellitus (KPD) is a subtype of type 2 diabetes, which presents much like type 1 diabetes, with dramatic hyperglycemia and ketoacidosis. Although KPD patients are initially insulin-dependent, after a few months of insulin treatment, roughly 70% undergo near-normoglycemia remission and can maintain blood glucose without insulin, as in early type 2 diabetes or prediabetes. Here, we propose that these phenomena can be explained by the existence of a fast, reversible glucotoxicity process, which may exist in all people but be more pronounced in those susceptible to KPD. We develop a simple mathematical model of the pathogenesis of KPD, which incorporates this assumption, and show that it reproduces the phenomenology of KPD, including variations in the ability for patients to achieve and sustain remission. These results suggest that a variation of our model may be able to quantitatively describe variations in the course of remission among individuals with KPD.https://elifesciences.org/articles/100193ketosis-prone diabetes mellitusdiabetes remissiondiabetes pathogenesismathematical modelingglucotoxicity
spellingShingle Sean A Ridout
Priyathama Vellanki
Ilya Nemenman
A mathematical model for ketosis-prone diabetes suggests the existence of multiple pancreatic β-cell inactivation mechanisms
eLife
ketosis-prone diabetes mellitus
diabetes remission
diabetes pathogenesis
mathematical modeling
glucotoxicity
title A mathematical model for ketosis-prone diabetes suggests the existence of multiple pancreatic β-cell inactivation mechanisms
title_full A mathematical model for ketosis-prone diabetes suggests the existence of multiple pancreatic β-cell inactivation mechanisms
title_fullStr A mathematical model for ketosis-prone diabetes suggests the existence of multiple pancreatic β-cell inactivation mechanisms
title_full_unstemmed A mathematical model for ketosis-prone diabetes suggests the existence of multiple pancreatic β-cell inactivation mechanisms
title_short A mathematical model for ketosis-prone diabetes suggests the existence of multiple pancreatic β-cell inactivation mechanisms
title_sort mathematical model for ketosis prone diabetes suggests the existence of multiple pancreatic β cell inactivation mechanisms
topic ketosis-prone diabetes mellitus
diabetes remission
diabetes pathogenesis
mathematical modeling
glucotoxicity
url https://elifesciences.org/articles/100193
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