T. Kawasaki, K. Igarashi, N. Ogata, Y. Oka, K. Ichiyanagi and T. Yamanouchi (2012). Markedly increased serum and urinary fructose concentrations in diabetic patients with ketoacidosis or ketosis. Acta diabetologica, 49(2), 119-23. https://doi.org/10.1007/s00592-010-0179-3

PubMed 20198392

[Abstract]
To investigate fructose concentrations in diabetic patients with ketoacidosis or ketosis, serum fructose concentrations and daily urinary fructose excretion were measured in 23 patients with ketoacidosis (n = 16) and ketosis (n = 7) on the first day of admission. Seventeen patients were diagnosed with type 1, one patient with mitochondrial, and 4 patients with atypical diabetes. In 16 of the 23 patients, serum and urinary fructose could be assessed after starting treatments. Mean serum fructose concentration was 71.6 ± 108.1 μmol/l, and mean daily urinary fructose excretion was 352.1 ± 473.7 μmol/day. Serum fructose levels in patients with atypical diabetes were much higher (205.0 ± 213.3 μmol/l) than those in patients with type 1 diabetes (45.1 ± 44.5 μmol/l), while urinary fructose levels in atypical diabetes (249.7 ± 92.4 μmol/day) tended to be lower than those in type 1 diabetes (382.6 ± 533.2 μmol/day). Serum fructose concentrations decreased significantly (P < 0.05) from 88.1 ± 126.3 to 18.0 ± 11.0 μmol/l, and daily urinary fructose excretion also decreased significantly (P < 0.05) from 459.8 ± 530.9 to 75.1 ± 62.0 μmol/day in accordance with glycemic normalization after treatment. Marked and reversible increases in serum and urinary fructose concentrations were observed in diabetics with ketoacidosis and ketosis.