Accuracy and Predictive Value of Classification Schemes for Ketosis-Prone Diabetes

Abstract

We have read with interest the study by Balasubramanyam et al. (1). They described a new classification scheme (Aβ classification) based on C-peptide levels and the presence or absence of β-cell autoantibodies to predict long-term β-cell function and insulin independence in patients who presented with diabetic ketoacidosis (DKA). They reported a sensitivity of 99.4%, a specificity of 95.9%, and a positive likelihood ratio (LR) of 24.55 in the total cohort of 294 subjects. In the subset of 138 subjects presenting with DKA as new-onset diabetes, 99.1%, 95.5%, and 21.79 sensitivity, specificity, and positive LR, respectively, were observed. To evaluate the performance of this new classification in a Caucasian-Spanish population, 40 consecutive adult …