Dr. Vivek Arya MD, DM(Endo.), SGPGI, Lucknow Asst. Prof. Smt. NHL Medical College & VS Hosp. Formerly Asst. Prof. Nizam’s Institute, Hyderabad Formerly, Chief Consultant and Head, Belhoul Apollo Hospital, DUBAI Senior Consultant Endocrinologist & SAL/Sterling/Shalby/Apollo/Nidhi Hospital Investigating Type 2 Diabetes & ADA EASD recommendations enter for ndocrine Disease and Diabetes
(Answer: detect sugar) What do these pictures have in common?
Women at very high risk should be screened for diabetes as soon as possible after the confirmation of pregnancy.
Criteria for very high risk are:
Prior history of GDM or delivery of large-for-gestational-age infant
Presence of glycosuria
Diagnosis of PCOS
Strong family history of type 2 diabetes
GDM Criteria *2 or more criteria met = positive diagnosis (cutoff points in mg/dl) † 1 or more criteria met = positive diagnosis 140 - 140 145 3 hours 155 ≥ 140 155 165 2 hours 180 - 180 190 1 hour 95 ≥ 126 95 105 Fasting Carpenter and Coustan* World health Organization † American Diabetes Association* National Diabetes Data Group*
The economic driving factors…… Adam Drewnowski and SE Specter. Poverty, obesity, and diet costs. Am J Clin Nutr 2004;79:6 –16 40/- per kg 90/- per kg … Consumer Price Index shifts favour unhealthy products
Type 2 or MODY Autosomal dominant Polygenic / Heterogen Inheritance rare frequent Obesity minimal considerable Role of environment beta cell dysfunction beta cell dysfunction + insulin resistance Patho-physiology child-young middle - old Age of onset MODY Type 2 DM
Diabetes Mellitus should be looked at as a whole with the metabolic syndrome.
Impaired fasting glycaemia and glucose tolerance should be given due importance
In the young the clinical features should be taken into account to determine the cause of diabetes.
Thank you Dr. Vivek Arya MD, DM(Endo.), SGPGI , Lucknow Asst. Prof. Smt. NHL Medical College & VS Hosp. Formerly Asst. Prof. Nizam’s Institute, Hyderabad Formerly, Chief Consultant and Head, Belhoul Apollo Hospital, DUBAI Senior Consultant Endocrinologist & SAL/Sterling/Apollo/Shalby/Nidhi Hospitals, Ahmedabad Mobile : 98795 37973 Phone : 2929 8877 enter for ndocrine disease and Diabetes