Secondary Diabetes Wiki

Infant Of Diabetic Mother

Author: Charles F Potter, MD; Chief Editor: Ted Rosenkrantz, MD more... Infants of diabetic mothers (IDMs) have experienced a nearly 30-fold decrease in morbidity and mortality rates since the development of specialized maternal, fetal, and neonatal care for women with diabetes and their offspring. Before then, fetal and neonatal mortality rates were as high as 65%. Today, 3-10% of pregnancies are affected by abnormal glucose regulation and control. Of these cases, 80-88% are related to abnormal glucose control of pregnancy or gestational diabetes mellitus. Of mothers with preexisting diabetes, 35% have been found to have type 1 diabetes mellitus, and 65% have been found to have type 2 diabetes mellitus. Infants born to mothers with glucose intolerance are at an increased risk of morbidity and mortality related to the following: Growth abnormalities (large for gestational age [LGA], small for gestational age [SGA]) Hypocalcemia , hypomagnesemia, and iron abnormalities These infants are likely to be born by cesarean delivery for many reasons, among which are such complications as shoulder dystocia with potential brachial plexus injury related to the infant's large size. These mothers must be closely monitored throughout pregnancy. If optimal care is provided, the perinatal mortality rate, excluding congenital malformations, is nearly equivalent to that observed in normal pregnancies. Communication between members of the perinatal team is of crucial importance to identify infants who are at the highest risk for complications from maternal diabetes. Fetal congenital malformations are most common when maternal glucose control has been poor during the first trimester of pregnancy. As such, the need for preconceptional glycemic control in women with diabetes cannot be overst Continue reading >>

Diabetes Mellitus Type 2

Diabetes mellitus type 2 (also known as type 2 diabetes) is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.[6] Common symptoms include increased thirst, frequent urination, and unexplained weight loss.[3] Symptoms may also include increased hunger, feeling tired, and sores that do not heal.[3] Often symptoms come on slowly.[6] Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations.[1] The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.[4][5] Type 2 diabetes primarily occurs as a result of obesity and lack of exercise.[1] Some people are more genetically at risk than others.[6] Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to diabetes mellitus type 1 and gestational diabetes.[1] In diabetes mellitus type 1 there is a lower total level of insulin to control blood glucose, due to an autoimmune induced loss of insulin-producing beta cells in the pancreas.[12][13] Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1C).[3] Type 2 diabetes is partly preventable by staying a normal weight, exercising regularly, and eating properly.[1] Treatment involves exercise and dietary changes.[1] If blood sugar levels are not adequately lowered, the medication metformin is typically recommended.[7][14] Many people may eventually also require insulin injections.[9] In those on insulin, routinely checking blood sugar levels is advised; however, this may not be needed in those taking pills.[15] Bariatri Continue reading >>

Secondary Diabetes

Tweet Secondary diabetes is diabetes that results as a consequence of another medical condition. Because the cause of diabetes ranges between different conditions, the way in which blood glucose levels are controlled can also vary. Secondary diabetes will often be permanent but for some forms, it may be possible to reverse or eradicate the effects of hyperglycemia. Which conditions can lead to secondary diabetes? Health conditions which can cause diabetes include: Cystic fibrosis Hemochromatosis Chronic pancreatitis Polycystic ovary syndrome (PCOS) Cushing's syndrome Pancreatic cancer Pancreatectomy Drug induced diabetes includes diabetes that results from taking certain medications. Medications which may bring on diabetes include corticosteroids, beta-blockers and thiazide diuretics. Read more on drug induced diabetes Managing secondary diabetes How secondary diabetes is managed can vary quite significantly depending on which condition has caused it. Insulin resistance Some medical conditions listed will result in insulin resistance, which is where the body is not able to adequately respond to insulin. This forces the body to release more insulin in an attempt to keep blood glucose levels under control. Insulin resistance is a characteristic of type 2 diabetes. Insulin resistance is a feature of diabetes caused by Cushing’s syndrome and PCOS. Lifestyle changes are an important part of treatment. If medication is required to control blood glucose levels, metformin is commonly prescribed with stronger medication, including insulin, available if blood glucose levels remain elevated. Loss of pancreatic function Some forms of secondary diabetes, such as diabetes as a result of pancreatitis, cystic fibrosis or hemochromatosis, may result in a loss of pancreatitic function; Continue reading >>

Introduction To Diseaseland Content

DiseaseLand is an integrated disease genomics database and visualization software that helps users explore public and private genomics datasets using OmicSoft's Land technology. DiseaseLand provides a user-friendly interface to functional genomics data for thousands of normal and disease samples, accelerating discovery of new connections in disease research. Omicsoft officially upgraded ImmunoLand and CVMLand into a single DiseaseLand in 2016. DiseaseLand is accessible via tiered subscriptions; users can choose to subscribe to immunological diseases, metabolic & cardiovascular diseases, or both.DiseaseLand focuses on datasets including, but not limited to, immunological diseases, metabolic diseases and cardiovascular diseases. Inherited from ImmunoLand, DiseaseLand includes immune-related diseases such as Asthma/Respiratory Diseases, Arthritis, Allergies, COPD, IBD, Psoriasis, SLE (systemic lupus erythematosus), Multiple Sclerosis, and Infectious Diseases. Projects from the former CVMLand provide data from cardiovascular diseases, diabetes mellitus, liver disease, lipid metabolism disorders and nutrition disorders. DiseaseLand contains datasets retrieved from a variety of public projects, from GEO (Gene Expression Omnibus), SRA (Sequence Read Archive), ArrayExpress, dbGAP (The Database of Genotypes and Phenotypes), and other large data repositories like ImmGen (The Immunological Genome Project). Moreover, DiseaseLand subscribers have access to the Body Map Collection, including BluePrint, GTEx, and HPA. Most data in DiseaseLand are collected in individual studies. The complexity of integrating these diverse studies requires careful management of data processing pipelines and well-controlled metadata curation With a heavy focus on publicly available expression microarra Continue reading >>

Principles Of Biochemistry/glucose, Glycogen And Diabetes

Glucose (C6H12O6, also known as D-glucose, dextrose, or grape sugar) is a simple sugar (monosaccharide) and an important carbohydrate in biology. Cells use it as a source of energy and a metabolic intermediate. Glucose is one of the main products of photosynthesis and starts cellular respiration. Glucose exists in several different structures, but all of these structures can be divided into two families of mirror-images (stereoisomers). Only one set of these isomers exists in nature, those derived from the "right-handed form" of glucose, denoted D-glucose. D-glucose is often referred to as dextrose. The term dextrose is derived from dextrorotatory glucose. Solutions of dextrose rotate polarized light to the right (in Latin: dexter = "right"). Starch and cellulose are polymers derived from the dehydration of D-glucose. The other stereoisomer, called L-glucose, is hardly found in nature. The name "glucose" comes from the Greek word glukus (γλυκύς), meaning "sweet". The suffix "-ose" denotes a sugar. The name "dextrose" and the 'D-' prefix come from Latin dexter ("right"), referring to the handedness of the molecules. Glucose is a monosaccharide with formula C6H12O6 or H-(C=O)-(CHOH)5-H, whose five hydroxyl (OH) groups are arranged in a specific way along its six-carbon backbone.[1] In its fleeting open-chain form, the glucose molecule has an open (as opposed to cyclic) and unbranched backbone of six carbon atoms, C-1 through C-6; where C-1 is part of an aldehyde group H(C=O)-, and each of the other five carbons bears one hydroxyl group -OH. The remaining bonds of the backbone carbons are satisfied by hydrogen atoms -H. Therefore glucose is an hexose and an aldose, or an aldohexose. Each of the four carbons C-2 through C-5 is chiral, meaning that its four bonds conne Continue reading >>

Diabetes Mellitus

"Diabetes" redirects here. For other uses, see Diabetes (disambiguation). Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period.[7] Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger.[2] If left untreated, diabetes can cause many complications.[2] Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death.[3] Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.[2] Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.[8] There are three main types of diabetes mellitus:[2] Type 1 DM results from the pancreas's failure to produce enough insulin.[2] This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".[2] The cause is unknown.[2] Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[2] As the disease progresses a lack of insulin may also develop.[9] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".[2] The most common cause is excessive body weight and insufficient exercise.[2] Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.[2] Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco.[2] Control of blood pressure and maintaining proper foot care are important for people with t Continue reading >>

Diabetes Mellitus Type 2: Symptoms, Complications, And Treatment

Diabetes Mellitus Type 2: Symptoms, Complications, and Treatment Diabetes Mellitus Type 2: Symptoms, Complications, and Treatment You can click on any of the links above to navigate to the section of your interest. Diabetes type 2 is the most common form of diabetes mellitus in the world. Insulin resistance by the body is the regularly observed cause of diabetes type 2. However, there is also another uncommon factor which causes diabetes type 2, that is, the body simply does not produce enough insulin. Insulin is a hormone produced by the pancreas that allows your body to use glucose (a type of sugar found in many carbohydrates) for energy. Insulin also helps to balance your blood glucose or blood sugar levels, by preventing it from getting too high (hyperglycemia) or too low (hypoglycemia). Following are the normal and diabetic blood sugar levels: Please Note: If your glucose levels are below 50 mg/dL or above 200 mg/dL you need to be admitted to the emergency room without delay. The primary cause of Diabetes Mellitus Type 2 is that the pancreas may produce enough insulin to transport sugar into the cells, however, the body refuses to use the insulin. Insulin helps to unlock the cells of the body to allow the sugar (glucose) to enter them so that the glucose is transformed into energy. If there is more sugar in the body than is required, the insulin helps to store the sugar in the liver and releases it when the blood sugar level is low, or when the body needs more sugar, such as in between meals or during vigorous physical activity. Therefore, insulin helps to balance out the blood sugar level and keep it in a normal range. As blood sugar level increases, the pancreas secrete more insulin. In diabetes type 2 since the body refuses to use the insulin produced, the insu Continue reading >>

Tecos - Wiki Journal Club

Among patients with type 2 diabetes and cardiovascular disease, does addition of sitagliptin to usual care increase the risk of adverse long-term cardiovascular events, compared to usual care only? Among patients with type 2 diabetes and cardiovascular disease, sitagliptin added to usual care did not increase the risk of major adverse cardiovascular events, hospitalization due to heart failure, or other adverse events. Concerns regarding the long-term cardiovascular safety of antihyperglycemic agents have been raised in several studies. [1] A meta-analysis published in 2007 suggested that rosiglitazone was associated with a significant increase in the risk of myocardial infarction (MI). [2] In 2009, the RECORD trial showed that addition of rosiglitazone to metformin or sulfonylurea significantly increased the risk of heart failure. [3] Sitagliptin is a dipeptidyl peptidase 4 (DPP-4) inhibitor which increases the level of glucagon-like peptide1 and glucose-dependent insulinotropic polypeptide. The net effect is a reduction in glucagon level and increased insulin secretion. The SAVOR-TIMI 53 trial and EXAMINE trial showed that the DPP-4 inhibitors sitagliptin and alogliptin did not increase or decrease the risk of major adverse CV events. [4] [5] However, the SAVOR-TIMI 53 showed that patients who received sitagliptin had a significantly higher rate of hospitalization for heart failure (3.5% vs. 2.8%; HR 1.27; 95% CI 1.07-1.51; P=0.007). The Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS) randomized 14,671 patients with type 2 diabetes (T2DM) and cardiovascular (CV) disease to receive either sitagliptin or placebo added to their existing therapy. The primary outcome of the trial is the composite of CV mortality, nonfatal MI, nonfatal stroke, or hospital Continue reading >>

Complications Of Diabetes Mellitus

The complications of diabetes mellitus are far less common and less severe in people who have well-controlled blood sugar levels. Acute complications include hypoglycemia and hyperglycemia, diabetic coma and nonketotic hyperosmolar coma. Chronic complications occur due to a mix of microangiopathy, macrovascular disease and immune dysfunction in the form of autoimmune disease or poor immune response, most of which are difficult to manage. Microangiopathy can affect all vital organs, kidneys, heart and brain, as well as eyes, nerves, lungs and locally gums and feet. Macrovascular problems can lead to cardiovascular disease including erectile dysfunction. Female infertility may be due to endocrine dysfunction with impaired signalling on a molecular level. Other health problems compound the chronic complications of diabetes such as smoking, obesity, high blood pressure, elevated cholesterol levels, and lack of regular exercise which are accessible to management as they are modifiable. Non-modifiable risk factors of diabetic complications are type of diabetes, age of onset, and genetic factors, both protective and predisposing have been found. Overview[edit] Complications of diabetes mellitus are acute and chronic. Risk factors for them can be modifiable or not modifiable. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels.[1][2][3] However, (non-modifiable) risk factors such as age at diabetes onset, type of diabetes, gender and genetics play a role. Some genes appear to provide protection against diabetic complications, as seen in a subset of long-term diabetes type 1 survivors without complications .[4][5] Statistics[edit] As of 2010, there were about 675,000 diabetes-related emergency department (ED) visits in the Continue reading >>

The Charcot Foot In Diabetes

The diabetic Charcot foot syndrome is a serious and potentially limb-threatening lower-extremity complication of diabetes. First described in 1883, this enigmatic condition continues to challenge even the most experienced practitioners. Now considered an inflammatory syndrome, the diabetic Charcot foot is characterized by varying degrees of bone and joint disorganization secondary to underlying neuropathy, trauma, and perturbations of bone metabolism. An international task force of experts was convened by the American Diabetes Association and the American Podiatric Medical Association in January 2011 to summarize available evidence on the pathophysiology, natural history, presentations, and treatment recommendations for this entity. The Charcot foot in diabetes poses many clinical challenges in its diagnosis and management. Despite the time that has passed since the first publication on pedal osteoarthropathy in 1883, we have much to learn about the pathophysiology, and little evidence exists on treatments of this disorder. The international task force was convened in January 2011 at the Salpêtrière Hospital in Paris, France, to review the literature and report on the definition, pathogenesis, diagnosis, and treatment of the diabetic Charcot foot. Recommendations in this report are solely the opinions of the authors and do not represent the official positions of the American Diabetes Association or the American Podiatric Medical Association. Charcot neuropathic osteoarthropathy (CN), commonly referred to as the Charcot foot, is a condition affecting the bones, joints, and soft tissues of the foot and ankle, characterized by inflammation in the earliest phase. The Charcot foot has been documented to occur as a consequence of various peripheral neuropathies; however, di Continue reading >>

Risk Factors And Aetiology Of Diabetes Mellitus

type 2 diabetes mellitus introduction it is thought that T2DM develops when a diabetogenic lifestyle (ie. excessive caloric intake, inadequate caloric expenditure, obesity) is superimposed on a susceptible genotype genetic factors prenatal factors hypertension hyperlipidaemia type 1 diabetes mellitus it is considered to be an autoimmune destruction of pancreatic β-cells in those who have genetic susceptibility and an environmental trigger (perhaps viral or toxin related) monozygotic twins will share the diagnosis more than 50% of the time by the age of 40 years child of mother with T1DM has 2-3% risk while child of father with T1DM has 5-6% risk, and 30% if both parents have T1DM Continue reading >>

The Uk Prospective Diabetes Study (ukpds): Clinical And Therapeutic Implications For Type 2 Diabetes

The UK Prospective Diabetes Study (UKPDS): clinical and therapeutic implications for type 2 diabetes 1Jenny ONeill Diabetes Centre, Derbyshire Royal Infirmary, Derby, UK 2Division of Vascular Medicine, School of Medical and Surgical Sciences, University of Nottingham, UK 1Jenny ONeill Diabetes Centre, Derbyshire Royal Infirmary, Derby, UK 2Division of Vascular Medicine, School of Medical and Surgical Sciences, University of Nottingham, UK Correspondence: Dr I. Peacock, Derbyshire Royal Infirmary, London Road, Derby, DE1 2QY, UK. Note added in proof We wish to pay tribute to Robert Turner whose recent untimely death is such a tragedy. Received 1999 Mar 15; Accepted 1999 Aug 24. Keywords: antihypertensives, diabetic complications, glycaemic control, oral hypoglycaemic agents, type 2 diabetes, UKPDS This article has been cited by other articles in PMC. Diabetes was first recognized 3500 years ago by the Ancient Egyptians. One of the first clinical descriptions was by Aretaeus, who practised in Cappadocia around 120 AD. He wrote that the condition was fortunately rare, but short will be the life of the man in whom the disease is fully developed [ 1 ]. In modern society, the first statement is far from true. The incidence of diabetes has doubled every 20 years since 1945 [ 2 ]. In 1994 the world wide prevalence of type 2 (non-insulin dependent) diabetes was 99 million (1.8% of the population); by 2010 it is estimated that this figure will rise to 215 million (3.8%) [ 3 ]. The second statement is as true today as it was almost 2000 years ago. In the West, 44% of patients with type 2 diabetes die within 10 years of diagnosis [ 4 ], mostly from macrovascular disease; the incidence of and mortality from cardiovascular disease are 23 times greater than in the general population Continue reading >>

Secondary Diabetes Mellitus

Also found in: Dictionary, Thesaurus, Encyclopedia. secondary diabetes mellitus DM that results from damage to the pancreas (e.g., after frequent episodes of pancreatitis) or from drugs such as corticosteroids (which increase resistance to the effects of insulin). diabetes mellitus a broadly applied term used to denote a complex group of syndromes that have in common a disturbance in the oxidation and utilization of glucose, which is secondary to a malfunction of the beta cells of the pancreas, whose function is the production and release of insulin. Because insulin is involved in the metabolism of carbohydrates, proteins and fats, diabetes is not limited to a disturbance of glucose homeostasis alone. Diabetes mellitus has been recorded in all species but is most commonly seen in middle-aged to older, obese, female dogs. A familial predisposition has been suggested. It is possible to identify two types of diabetes, corresponding to the disease in humans, depending on the response to an intravenous glucose tolerance test. Type I is insulin-dependent and comparable to the juvenile onset form of the disease in children in which there is an absolute deficiency of insulin—there is a very low initial blood insulin level and a low response to the injected glucose. This form is seen in a number of dog breeds, particularly the Keeshond, Doberman pinscher, German shepherd dog, Poodle, Golden retriever and Labrador retriever. Type II is non-insulin-dependent, similar to the adult onset diabetes in humans due to pancreatic damage—there is a high or normal initial blood insulin level and no increase in insulin levels as a result of the glucose load. It is the form seen most often in cats. brittle diabetes mellitus diabetes mellitus that is difficult to control, characterized by Continue reading >>

Other Types Of Diabetes Mellitus

In most cases of diabetes, referred to as type 1 and type 2, no specific cause can be identified. This is referred to as primary or idiopathic diabetes. A small minority of cases, estimated at about 2%, arise as the consequence of some other well-defined disease or predisposing factor such as pancreatitis or steroid excess. This is called 'secondary diabetes'. Secondary diabetes can be sub-divided into single-gene disorders affecting insulin secretion or resistance, damage to the exocrine pancreas, other endocrine disease, drug-induced diabetes, uncommon manifestations of autoimmune diabetes, and genetic syndromes associated with diabetes. Gestational diabetes (diabetes arising for the first time in pregnancy) has a diagnostic category all to itself, but is included in this section for convenience. Secondary diabetes is often (but not always) associated with a relatively mild metabolic disturbance, but may nonetheless result in typical long-term complications such as retinopathy. Although it is relatively uncommon, the possibility of secondary diabetes should always be considered, since it may be a pointer to other disease, often requires a different approach to therapy, and is sometimes reversible. Background The common denominator of all the forms of diabetes discussed here is that something sets them apart from type 1 and type 2 diabetes. Since type 2 diabetes is hard to define, this implies that for most forms of diabetes in this category there is a pointer to a different pathophysiological explanation! The current WHO classification of diabetes, adopted and regularly updated by the American Diabetes Association, identifies four main categories of diabetes, and secondary diabetes is clssified under 'other specific types' (see figures). The common categories of secon Continue reading >>

Pancreatogenic (type 3c) Diabetes

1. Definition Pancreatogenic diabetes is a form of secondary diabetes, specifically that associated with disease of the exocrine pancreas. The most common disease of the exocrine pancreas associated with the development of diabetes is chronic pancreatitis. Analogous to chronic pancreatitis-associated diabetes is cystic fibrosis-related diabetes (CFRD), in which pancreatic exocrine insufficiency pre-dates the pancreatic endocrine insufficiency responsible for the development of diabetes. Because diabetes in cystic fibrosis is associated with worse nutritional status, more severe inflammatory lung disease, and greater mortality from respiratory failure, CFRD has long been recognized as a distinct form of diabetes requiring a specified approach to evaluation and treatment (30) now recognized by the American Diabetes Association (28). While the distinct pathogenesis of diabetes in chronic pancreatitis has also long been appreciated, only recently have guidelines been developed supporting a specified diagnostic and therapeutic algorithm (37). Finally, other less common forms of pancreatogenic diabetes exist, such as that due to pancreatic cancer (18), as well as post-pancreatectomy diabetes, with each requiring individualized approaches to care. 2. Classification Pancreatogenic diabetes is classified by the American Diabetes Association and by the World Health Organization as type 3c diabetes mellitus (T3cDM) and refers to diabetes due to impairment in pancreatic endocrine function related to pancreatic exocrine damage due to acute, relapsing and chronic pancreatitis (of any etiology), cystic fibrosis, hemochromatosis, pancreatic cancer, and pancreatectomy, and as well rare causes such as neonatal diabetes due to pancreatic agenesis (1). Prevalence data on T3cDM are scarce b Continue reading >>