# Mechanisms of ketosis and near-normoglycemia remission in obese African Americans with ketosis-prone diabetes

> **NIH NIH R03** · EMORY UNIVERSITY · 2022 · $117,375

## Abstract

Project Summary/Abstract
It is estimated that ketosis-prone diabetes mellitus (KPDM) affects 20-50% of African American patients with
newly diagnosed diabetes who present with diabetic ketoacidosis (DKA). At presentation of DKA, these
patients have a severe decompensation in insulin secretion accompanied by severe insulin resistance. Unlike
patients with type 1 diabetes, following intensive insulin treatment, many of these patients exhibit
improvements in insulin secretion and insulin sensitivity and are able to discontinue insulin therapy (near-
normoglycemia remission, HbA1c < 7%, fasting glucose < 130 mg/dl while off insulin for at least one week).
The period of near-normoglycemia remission is variable and many patients eventually experience a
hyperglycemic relapse or even DKA while some stay in remission due to sustained insulin secretion. Despite
the phenotype being recognized for many years, the underlying mechanisms leading to ketosis and
maintenance of beta-cell function are unknown. Further, increased intra-organ (pancreas and liver) fat can also
play a role in remission. High resolution metabolomics and magnetic resonance imaging offer a comprehensive
way to assess multiple pathways and imaging characteristics. This proposal will leverage already collected
samples and participants from the PI’s K23 proposal to examine pathways leading to ketosis and sustained
remission. Aim 1 will compare metabolomic signatures between people with DKA and hyperglycemia without
ketosis. Aim 2 will compare metabolomic signatures at time of insulin discontinuation and their relationship with
sustained beta-cell function. Aim 3 will explore whether differences in pancreatic and hepatic fat associate with
sustained remission and beta-cell function. The Aims, together with new collaborators with complementary
expertise will generate data to explore novel hypotheses for new independent proposals by the PI.

## Key facts

- **NIH application ID:** 10528011
- **Project number:** 1R03DK129627-01A1
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Priyathama Vellanki
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $117,375
- **Award type:** 1
- **Project period:** 2022-08-05 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10528011

## Citation

> US National Institutes of Health, RePORTER application 10528011, Mechanisms of ketosis and near-normoglycemia remission in obese African Americans with ketosis-prone diabetes (1R03DK129627-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10528011. Licensed CC0.

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