Monday, 18 August 2014

Diabetes

Latent autoimmune diabetes of adults (LADA), often also late-onset autoimmune diabetes of adulthood or aging,[1] slow onset type 1 diabetes or diabetes type 1.5 is a form of diabetes mellitus type 1 that occurs in adults, often with a slower course of onset. Adults with LADA may initially be diagnosed as having type 2 diabetes based on their age, particularly if they have risk factors for type 2 diabetes such as a strong family history or are obese.
The diagnosis is based on the finding of high blood sugar together with the clinical impression that islet failure rather than insulin resistance is the main cause; detection of a low C-peptide and raised antibodies against the islets of Langerhans support the diagnosis. It cannot be treated with the usual oral treatments for type 2 diabetes, and insulin treatment is usually necessary, as well as long-term monitoring for complications. The concept of LADA was first introduced in 1993.
latent diabetes - a mild form of diabetes mellitus in which there are no overt symptoms but there are abnormal responses to some diagnostic procedures,A persn who becums diabetic under stressful situatn like pregnancy nd again becums non diabetic whn stress is removed ...
Brittle diabetes mellitus (or labile diabetes) is a term used to describe particularly hard to control type 1 diabetes.
🔺Those people who have brittle diabetes will experience frequent, extreme swings in blood glucose levels, causing hyperglycemia or hypoglycemia.
🔺The life expectancy for someone with brittle diabetes is no different to someone who has type 1 or type 2 diabetes.
🔺In fact, brittle diabetes can also be described poorly controlled type 2 diabetes.
🔺Brittle diabetes is rare but serious. Around 3 in 1,000 people with type 1 diabetes mellitus will develop brittle diabetes.
A person who is NOT diabetic on presentation bt 4m a strong Family history of DM 2 .. .... is calld a potential diabetic....
The following characteristics suggest the possibility of a diagnosis of MODY in hyperglycemic and diabetic patients:
🔺Mild to moderate hyperglycemia (typically 130–250 mg/dl, or 7–14 mmol/l) discovered before 30 years of age. However, anyone under 50u can develop MODY.
🔺A first-degree relative with a similar degree of diabetes.
🔺Absence of positive antibodies or other autoimmunity (e.g., thyroiditis) in patient and family.
🔺Persistence of a low insulin requirement (e.g., less than 0.5 u/kg/day) past the usual "honeymoon" period.
🔺Absence of obesity (although overweight or obese people can get MODY) or other problems associated with type 2 diabetes or metabolic syndrome (e.g., hypertension, hyperlipidemia, polycystic ovary syndrome).
🔺Insulin resistance very rarely happens.
🔺Cystic kidney disease in patient or close relatives.
🔺Non-transient neonatal diabetes, or apparent type 1 diabetes with onset before six months of age.
🔺Liver adenoma or hepatocellular carcinoma in MODY type 3
🔺Renal cysts, rudimentary or bicornuate uterus, vaginal aplasia, absence of the vas deferens, epidymal cysts in MODY type 5
Genetic defects in beta cell function caused by mutations in subunits of ATP sensitivr K channels... a form of neonatal onset diab..SUs found effective
In MODY2, oral agents are relatively ineffective and insulin is unnecessary.
In MODY1 and MODY3, insulin may be more effective than drugs to increase insulin sensitivity
After d initial clinical presentations of type1 DM a honeymoon phase may ensue during which time glycemic control s achieved wid modest doses of insulin or rarely insulin s not needed at all
DQA1*0102 DQB1*0602 dese haplotypes r extremely rare in pts wid type1DM(<1%) and appears to provide protection from typ1DM
Relatives of individuals wid type1 DM-tenfold increased risk of developing t
Parents hav diabetes-3-4% risk
Sibling5-15%
Homozygous glucokinase mutations cause a severe form of neonatal diabetes
COCAINE precipitates DKA
Monoclonal ab 4 prevention of type1 DM -CD3

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