Autoimmune destruction of the insulin producing islet beta cells Insulin deficient: insulin dependent Usually young, but can be ANY age Autoantibody tests: ICA, IA2, GAD Often other endocrine disorders in patient or family
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What is LADA?
Presents often as ‘type 2’ diabetes- Autoantibodies: GAD, ICA, tTG, TPO- Progressive deterioration in control, increasing therapy
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What is type2 diabetes?
Insulin resistant/deficient Not absolutely insulin dependent Strong family history Often obese or overweight Usually hypertensive and hyperlipidaemic
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What is TYPE 2 DIABETES VARIANT ‘KETOSIS-PRONE TYPE 2’?
Often obese, ethnic minority Ketosis when physically stressed with intercurrent illness Temporarily requites insulin Not insulin dependent
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What disorders can cause diabetes secondary to pancreatic disorders?
Chronic or acute pancreatitis Calcific, tropical pancreatitis Pancreatectomy Pancreatic cancer Cystic fibrosis Haemochromatosis
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What drugs can cause drug induced diabetes?
1) diuretics 2) steroids 3) antipsychotics e.g. olanzapine 4) psychiatric drugs- weight gain- treatment emergent diabetes seen in newer atypical antipsychotic treatment
J type diabetes: ‘Jamaican’ diabetes, Afro-Caribbeans Flatbush diabetes: US Afro-Americans MRDM: malnutrition- related diabetes, tropical diabetes Chronic calcific pancreatitis: secondary diabetes Z type diabetes
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Describe J type jamaican diabetes
Ketosis prone Not particularly obese On and off insulin therapy Variable insulin requirements Also called Flatbush diabetes
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What genetic syndromes can cause diabetes?
1) friedreich's ataxia 2) dystrophia myotonica
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What is gestational diabetes?
Diabetes appears during pregnancy Diabetes resolves after pregnancy At risk of diabetes in later pregnancy At risk of diabetes in future Pregnancy in the known diabetic case Diabetes arising or diagnosed in pregnancy
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What is MODY? (Maturity onset diabetes in the young: Mason diabetes, Tattersall & Fajans)
Autosomal dominant pattern 1-2% of diabetic cases Onset under 25 Insulin not required initially Glucokinase, HNF 1A, HNF 4A
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