Diabetes Types
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Most people will know the two main diabetes types, simply called Type I and Type II, but at least th... Read more at: http://www.living-healthy-with-diabetes.com/diabetes-types.html
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Secondary diabetes
Secondary diabetes occurs when diabetes is caused by another underlying condition or medical treatment. Some examples of secondary diabetes included cystic fibrosis related diabetes, which occurs when cystic fibrosis damages the pancreas, preventing proper insulin production. Hemochromatosis, also called "bronze diabetes", occurs when excess iron absorption causes skin darkening and hyperglycemia. Conditions like pancreatitis, polycystic ovary syndrome, Cushing's syndrome, and rare tumors can also potentially lead to secondary diabetes by impacting insulin regulation and production.
Drug induced diabetes
Many medications can cause drug-induced diabetes by increasing insulin resistance or affecting insulin secretion. Widely used medications like thiazide diuretics, beta-blockers, and statins weakly increase diabetes risk, while steroids, antipsychotics, immunosuppressants, protease inhibitors confer a high risk. Diabetes induced by medications may not always be permanent and blood glucose levels could return to normal after stopping the medication, but lifestyle changes are often needed to manage drug-induced diabetes.
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in this slide i have given a little information about latent autoimmune diabetes in adult and maturity onset diabetes in young
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This document discusses various drug classes used to treat type 2 diabetes, including their mechanisms of action, pharmacokinetics, and side effects. It describes sulfonylureas, metformin, thiazolidinediones, meglitinide analogues, DPP-4 inhibitors, GLP-1 receptor agonists, alpha-glucosidase inhibitors, amylin analogues, and SGLT2 inhibitors. For each class, it provides details on representative drugs, how they work, considerations around use, and common adverse effects. The document aims to comprehensively cover oral and injectable pharmacologic options for managing hyperglycemia in type 2 diabetes.
LADA: Latent Autoimmune Diabetes in Adults
A 42-year-old male presented with excessive urination and fatigue over the past 8 months. Laboratory tests showed elevated fasting blood glucose, post-prandial blood glucose, HbA1c, and ketones in the urine. Further testing found low C-peptide levels and positive GAD antibodies, confirming a diagnosis of latent autoimmune diabetes in adults (LADA), a type of diabetes that shares characteristics of both type 1 and type 2 diabetes. LADA is characterized by autoimmune destruction of the pancreatic beta cells and low insulin production in adults, treated primarily with insulin therapy.
Monogenic diabetes
This document discusses monogenic diabetes, which is caused by mutations in single genes. It can mimic type 1 or type 2 diabetes but occurs independently of environmental factors. Diagnosing monogenic diabetes is important because it can change treatment approaches, such as replacing insulin injections with tablets in some forms. The document outlines different pathogenic classifications of monogenic diabetes and provides examples like neonatal diabetes, Wolcott-Rallison syndrome, and Wolfram syndrome. Careful patient selection is needed before molecular testing to correctly diagnose the underlying genetic cause of monogenic diabetes.
Type 1 Diabetes Mellitus - Etiology
Type 1 Diabetes Mellitus is a form of diabetes mellitus that results from the autoimmune destruction of the insulin-producing beta cells in the pancreas. Genetic factors are believed to be a major com- ponent for the development of type 1diabetes, but the con- cordance rate for the development of diabetes in identical twins is only about 40%, suggesting that non-genetic factors play an important role in the expression of the disease. Viruses are one environmental factor that is implicated in the pathogenesis of type 1 diabetes mellitus.
Shashikiran Umakanth made this presentation at the "First Endocrine Update Program” – ENDO EGYPT 2015, from 17-20 December 2015 in the Historic City of Luxor, Egypt. This endocrine update was organised by the Egyptian Association of Endocrinology , Diabetes and Atherosclerosis (EAEDA) in collaboration with the Endocrine Society, USA.
LADA & MODY DIABETES
MODY, or Maturity-Onset Diabetes of the Young, is a form of diabetes that is caused by single-gene mutations. It is characterized by an onset of diabetes early in life, often before age 25, and autosomal dominant inheritance. There are several subtypes of MODY based on the gene involved, including MODY1-6. MODY often presents with mild, stable hyperglycemia that does not progress rapidly and may initially respond to oral medications rather than insulin injections. Genetic testing can confirm a MODY diagnosis but is not necessary as clinical features are also diagnostic. Management depends on the specific gene mutation but usually involves diet, exercise and oral medications long-term.
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Secondary diabetes
Secondary diabetes occurs when diabetes is caused by another underlying condition or medical treatment. Some examples of secondary diabetes included cystic fibrosis related diabetes, which occurs when cystic fibrosis damages the pancreas, preventing proper insulin production. Hemochromatosis, also called "bronze diabetes", occurs when excess iron absorption causes skin darkening and hyperglycemia. Conditions like pancreatitis, polycystic ovary syndrome, Cushing's syndrome, and rare tumors can also potentially lead to secondary diabetes by impacting insulin regulation and production.
Drug induced diabetes
Many medications can cause drug-induced diabetes by increasing insulin resistance or affecting insulin secretion. Widely used medications like thiazide diuretics, beta-blockers, and statins weakly increase diabetes risk, while steroids, antipsychotics, immunosuppressants, protease inhibitors confer a high risk. Diabetes induced by medications may not always be permanent and blood glucose levels could return to normal after stopping the medication, but lifestyle changes are often needed to manage drug-induced diabetes.
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LADA: Latent Autoimmune Diabetes in Adults
A 42-year-old male presented with excessive urination and fatigue over the past 8 months. Laboratory tests showed elevated fasting blood glucose, post-prandial blood glucose, HbA1c, and ketones in the urine. Further testing found low C-peptide levels and positive GAD antibodies, confirming a diagnosis of latent autoimmune diabetes in adults (LADA), a type of diabetes that shares characteristics of both type 1 and type 2 diabetes. LADA is characterized by autoimmune destruction of the pancreatic beta cells and low insulin production in adults, treated primarily with insulin therapy.
Monogenic diabetes
This document discusses monogenic diabetes, which is caused by mutations in single genes. It can mimic type 1 or type 2 diabetes but occurs independently of environmental factors. Diagnosing monogenic diabetes is important because it can change treatment approaches, such as replacing insulin injections with tablets in some forms. The document outlines different pathogenic classifications of monogenic diabetes and provides examples like neonatal diabetes, Wolcott-Rallison syndrome, and Wolfram syndrome. Careful patient selection is needed before molecular testing to correctly diagnose the underlying genetic cause of monogenic diabetes.
Type 1 Diabetes Mellitus - Etiology
Type 1 Diabetes Mellitus is a form of diabetes mellitus that results from the autoimmune destruction of the insulin-producing beta cells in the pancreas. Genetic factors are believed to be a major com- ponent for the development of type 1diabetes, but the con- cordance rate for the development of diabetes in identical twins is only about 40%, suggesting that non-genetic factors play an important role in the expression of the disease. Viruses are one environmental factor that is implicated in the pathogenesis of type 1 diabetes mellitus.
Shashikiran Umakanth made this presentation at the "First Endocrine Update Program” – ENDO EGYPT 2015, from 17-20 December 2015 in the Historic City of Luxor, Egypt. This endocrine update was organised by the Egyptian Association of Endocrinology , Diabetes and Atherosclerosis (EAEDA) in collaboration with the Endocrine Society, USA.
LADA & MODY DIABETES
MODY, or Maturity-Onset Diabetes of the Young, is a form of diabetes that is caused by single-gene mutations. It is characterized by an onset of diabetes early in life, often before age 25, and autosomal dominant inheritance. There are several subtypes of MODY based on the gene involved, including MODY1-6. MODY often presents with mild, stable hyperglycemia that does not progress rapidly and may initially respond to oral medications rather than insulin injections. Genetic testing can confirm a MODY diagnosis but is not necessary as clinical features are also diagnostic. Management depends on the specific gene mutation but usually involves diet, exercise and oral medications long-term.
Signs of Diabetes
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Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
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Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
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Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
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About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
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