Journal articles on the topic 'Non-insulin-dependent diabetes Diagnosis'
To see the other types of publications on this topic, follow the link: Non-insulin-dependent diabetes Diagnosis.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Non-insulin-dependent diabetes Diagnosis.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Singh, B. M., D. M. Jackson, R. Wills, J. Davies, and P. H. Wise. "Delayed diagnosis in non-insulin dependent diabetes mellitus." BMJ 304, no. 6835 (May 2, 1992): 1154–55. http://dx.doi.org/10.1136/bmj.304.6835.1154.
Full text
2
Pishdad, G. R. "Age at Diagnosis of Non-Insulin-Dependent Diabetes Mellitus in Southern Iran." Journal of International Medical Research 23, no. 5 (September 1995): 381–85. http://dx.doi.org/10.1177/030006059502300509.
Full textAbstract:
To obtain an estimate of the age at onset of non-insulin-dependent diabetes mellitus in southern Iran, the medical records of the confirmed diabetic patients who attended the diabetes and endocrine clinics in southern Iran from March 1984 to February 1993 were reviewed. The case records of 2566 patients, in whom non-insulin-dependent diabetes mellitus was considered most probable, and who were resident in southern Iran at the time of diagnosis, were studied; they included 1176 (45.8%) men and 1390 (54.2%) women. The age at diagnosis of the disease in men ranged between 18 and 82 years with a mean of 45.6 ± 11.4 (± SD) years, and in women, between 15 and 83 with a mean of 44.3 ± 12.2 (± SD) years. There was no statistically significant sex-related difference in the mean age at diagnosis of non-insulin-dependent diabetes mellitus in these patients. Sex-specific rates showed a female to male ratio of 1.25 to 1. Age-specific rates indicated that non-insulin-dependent diabetes mellitus was most often diagnosed before age 55 and most commonly in the forties.
3
Hopkins, KD. "Clues to the diagnosis of non-insulin-dependent diabetes in children." Lancet 350, no. 9072 (July 1997): 189. http://dx.doi.org/10.1016/s0140-6736(05)62357-4.
Full text
4
Ruggenenti, Piero, and Giuseppe Remuzzi. "The diagnosis of renal involvement in non-insulin-dependent diabetes mellitus." Current Opinion in Nephrology and Hypertension 6, no. 2 (March 1997): 141–45. http://dx.doi.org/10.1097/00041552-199703000-00006.
Full text
5
Plotnick, Leslie. "Insulin-dependent Diabetes Mellitus." Pediatrics In Review 15, no. 4 (April 1, 1994): 137–48. http://dx.doi.org/10.1542/pir.15.4.137.
Full textAbstract:
Insulin-dependent diabetes mellitus (IDDM) is a chronic, serious disease in children and adolescents. Its diagnosis is straightforward and rarely subtle. The major challenges of this disease for the child, family, and health-care team involve long-term management of medical and metabolic factors as well as psychological and behavioral concerns. While developments in the past 10 to 15 years have made metabolic control technically possible, psychological stresses and behavioral problems often interfere with metabolic goals. There are few, if any, other diseases that require such intensive and extensive self-care skills. Definitions Diabetes generally is classified in two types. Type I, or IDDM, is seen mostly in younger people (children and adolescents). It previously was called juvenile onset or ketosisprone. Insulin deficiency characterizes IDDM, and patients need exogenous insulin for survival. Type II, or non-IDDM (NIDDM), previously called adult or maturity onset, is the type seen most commonly in older people and in obesity and is not discussed in this review. To make a diagnosis of diabetes, a child must have either classic symptoms with a random plasma glucose above 200 mg/dL or specific plasma glucose levels before and after a standard glucose load if asymptomatic. The diagnosis of IDDM usually is clear-cut.
6
&NA;. "CARING FOR PATIENTS WITH NON-INSULIN-DEPENDENT. DIABETES MELLITUS." Nursing 26, no. 9 (September 1996): 48–50. http://dx.doi.org/10.1097/00152193-199609000-00016.
Full text
7
Fielding, Andrew M., Sinead Brophy, Helen Davies, and Rhys Williams. "Latent autoimmune diabetes in adults: increased awareness will aid diagnosis." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 44, no. 4 (July 1, 2007): 321–23. http://dx.doi.org/10.1258/000456307780945679.
Full textAbstract:
Latent autoimmune diabetes iln adults (LADA) is the term used for patients with non-insulin dependent diabetes who progress to insulin dependency as their pancreatic secretion of insulin fails. Diagnosis is based on adult age at the time of diabetes, the presence of serum autoantibodies to pancreatic antigens and the absence of a requirement for insulin at diagnosis. High titres of serum glutamic acid decarboxylase (GAD) antibodies act as a marker for LADA. Serum C-peptide concentrations are also lower in autoimmune diabetic patients. The best treatment for patients with LADA is not clear, but early insulin treatment may prevent pancreatic β-cell failure.
8
El Hazmi, Mohsen A. F., A. B. Warsy, and R. Sulairnani. "Diabetesmellitus as a health problem in Saudi Arabia." Eastern Mediterranean Health Journal 4, no. 1 (January 15, 1998): 58–67. http://dx.doi.org/10.26719/1998.4.1.58.
Full textAbstract:
A total of 25 337 Saudis [11 713 males [46.2%] and 13 624 females [53.8%] were screened for diabetes mellitus and impaired glucose tolerance using WHO criteria for diagnosis. The prevalence of insulin-dependent diabetes mellitus, non-insulin-dependent diabetes mellitus and impaired glucose tolerance in the total Saudi male population was 0.23%, 5.63% and 0.50% respectively, and in the total Saudi female population was 0.30%, 4.53% and 0.72% respectively. Differences were observed in the prevalence of diabetes mellitus and impaired glucose tolerance between the provinces. Non-insulin-dependent diabetes mellitus increased to 28.82% and 24.92% in males and females respectively over the age of 60 years, while impaired glucose tolerance increased to 1.60% and 3.56%
9
NK, Sunčana. "Occurrence of Pancreatic Cancer Associated Insulin Dependent Diabetes." Cancer Research and Cellular Therapeutics 1, no. 3 (September 8, 2017): 01–03. http://dx.doi.org/10.31579/2640-1053/016.
Full textAbstract:
Patients with pancreatic cancer often present with non-specific symptoms and are often diagnosed at an advanced stage. The relationship between diabetes and the development of pancreatic cancer has been an area of intense research. In the present study we specifically aim to look at the hypothesis that the incidence of insulin dependent diabetes increases after the onset of pancreatic cancer. Materials and Methods: We retrospectively reviewed the chart of all pancreatic cancer patients in tumor registry admitted to University of Florida Tumor Registry in Jacksonville, Florida. Data was collective from January 2000 and December 2006. Each patient’s record was reviewed for histologic biopsy, demographic information, presence of risk factors, co-morbidities, presence and duration of diabetes. Assessment of diabetes was based on the guidelines provided by American Diabetes Association. Results: 82 patients were identified from the University of Florida Cancer Registry from the year 2000-2006. Complete data was available on 76 patients. Mean age at diagnosis was 66.4 years. 53 (69.7%) were African American, 23 (30.26%) were white. There was an equal male/female distribution of 1:1.07 (43 males; 40 females). 35 (46.0%) patients were smokers. Most common presentation was with obstructive jaundice (33/76 or 43.4%) followed by typical symptoms of weight loss, fatigue, abdominal and back pain (31/76 or 40.78%). In 11 (14.47%) patients, pancreatic cancer was noted as an incidental finding. Staging at the time of diagnosis was available in 76 patients. 48 (63.1%) patients were in Stage 4, 13 (17.1%) patients were in Stage 3, 10 (13.15%) patients were at stage 2 and 5 (6.5%) patients were in Stage 1. 15(19.7%) patients had diabetes at the time of diagnosis of pancreatic cancer. 5 (6.5%) developed one or more deep vein thrombosis (DVTs) after the diagnosis of PC. Diabetes was present in 15 (19.7%) for an average duration of 19 months. Only 4(26.6%) out of 15 patients were on insulin therapy before the diagnosis of pancreatic cancer. Six additional patients (an increase of 7.93%) developed diabetes after the diagnosis of pancreatic cancer. 13 (61.9%) of the 21 patients required insulin therapy after the diagnosis of pancreatic cancer. As many as 27 (35%) patients opted for hospice care after the diagnosis of pancreatic cancer. Whipple’s procedure or exploratory debulking surgery of the tumor was performed in 33 (43%) patients. 29 (38.1%) patients received Gemcitabine/carboplatin/5 FU based chemotherapy. Conclusion: We found that the Incidence of Insulin-dependent diabetes increased in patients diagnosed with pancreatic cancer.
10
Martin, P., and K. K. Hampton. "A Longitudinal Study of Microproteinuria in non-Insulin Dependent Diabetes Mellitus from Diagnosis." Clinical Science 77, s21 (December 1, 1989): 17P. http://dx.doi.org/10.1042/cs077017pb.
Full text
11
Lin, Hu, Xuelian Zhou, Xuefeng Chen, Ke Huang, Wei Wu, Junfen Fu, Yangxi Li, Constantin Polychronakos, and Guan-Ping Dong. "tRNA methyltransferase 10 homologue A (TRMT10A) mutation in a Chinese patient with diabetes, insulin resistance, intellectual deficiency and microcephaly." BMJ Open Diabetes Research & Care 8, no. 1 (October 2020): e001601. http://dx.doi.org/10.1136/bmjdrc-2020-001601.
Full textAbstract:
IntroductionLoss-of-function mutations in tRNA methyltransferase 10 homologue A (TRMT10A), a tRNA methyltransferase, have recently been described as a monogenic cause of early-onset diabetes with microcephaly, epilepsy and intellectual disability.Research design and methodsWe report a Chinese young patient who was diagnosed with diabetes mellitus as a result of a TRMT10A mutation.ResultsA homozygous mutation c.496–1G>A in TRMT10A was identified using targeted next-generation sequencing and confirmed by PCR/Sanger sequencing. In addition to being diagnosed with diabetes, the patient also has microcephaly and intellectual deficiency. The diabetes was due to marked insulin resistance and responded very well to metformin treatment.ConclusionOur case is the first report in the Asian population. It adds to current knowledge of TRMT10A related with young-onset non-insulin-dependent diabetes and confirms the a single previous report of insulin resistance in this syndrome. Genomic testing should be considered in children with non-insulin-dependent diabetes with intellectual disability and microcephaly. A clear genetic diagnosis is helpful for early detection and treatment addressing insulin resistance.
12
Barbato, Mariana Tremel, Paulo Ricardo Criado, Ana Kris da Silva, Evelyne Averbeck, Marina Bensen Guerine, and Naiana Bittencourt de Sá. "Association of acanthosis nigricans and skin tags with insulin resistance." Anais Brasileiros de Dermatologia 87, no. 1 (February 2012): 97–104. http://dx.doi.org/10.1590/s0365-05962012000100012.
Full textAbstract:
Insulin resistance is a metabolic disorder in which target cells fail to respond to normal levels of circulating insulin. Insulin resistance has been associated with presence of acanthosis nigricans and acrochordons. It is known that early diagnosis and early initial treatment are of paramount importance to prevent a series of future complications. These dermatoses may represent an easily identifiable sign of insulin resistance and non-insulin-dependent diabetes.
13
Møller-Jensen, B., K. Buschard, I. Buch, L. Mølsted-Pedersen, C. Kühl, B. K. Jakobsen, and A. Svejgaard. "HLA associations in insulin-dependent diabetes mellitus diagnosed during pregnancy." Acta Endocrinologica 116, no. 3 (November 1987): 387–89. http://dx.doi.org/10.1530/acta.0.1160387.
Full textAbstract:
Abstract. Sixty out of 63 patients with insulin-dependent diabetes mellitus (IDDM) diagnosed during pregnancy in the Diabetes Centre at the Department of Obstetrics and Gynaecology, Rigshospitalet, Copenhagen, were re-examined 2–16 years after diagnosis. Fourty-six patients were currently insulin-treated and the remaining 14 patients were all severely glucose intolerant. HLA-typing was carried out in 41 of these patients. The HLA phenotype distribution showed a highly significant difference from that of non-diabetics but was similar to that seen in IDDM not related to pregnancy. Thus, pregnancy may constitute a special trigger mechanism for IDDM, but the subsequent pathogenic mechanisms are probably the same as those involved in other cases of IDDM.
14
Hillson, R. M., T. D. R. Hockaday, D. J. Newton, and B. Pim. "Delayed Diagnosis of Non-insulin-dependent Diabetes is Associated with Greater Metabolic and Clinical Abnormality." Diabetic Medicine 2, no. 5 (September 1985): 383–86. http://dx.doi.org/10.1111/j.1464-5491.1985.tb00657.x.
Full text
15
Yoshioka, Keiji. "A case of non-insulin-dependent diabetes mellitus with vertebral osteomyelitits: usefulness of imaging diagnosis." Diabetes Research and Clinical Practice 29, no. 3 (September 1995): 211–14. http://dx.doi.org/10.1016/0168-8227(95)01129-3.
Full text
16
Songer, T. J., R. E. LaPorte, N. Tajima, T. J. Orchard, B. S. Rabin, M. S. Eberhardt, J. S. Dorman, K. J. Cruickshanks, D. E. Cavender, and D. J. Becker. "Height at diagnosis of insulin dependent diabetes in patients and their non-diabetic family members." BMJ 292, no. 6533 (May 31, 1986): 1419–22. http://dx.doi.org/10.1136/bmj.292.6533.1419.
Full text
17
Bahadur, Erfanul Hoque, Abdul Kadar Muhammad Masum, Arnab Barua, and Md Zia Uddin. "Active Sense: Early Staging of Non-Insulin Dependent Diabetes Mellitus (NIDDM) Hinges upon Recognizing Daily Activity Pattern." Electronics 10, no. 18 (September 8, 2021): 2194. http://dx.doi.org/10.3390/electronics10182194.
Full textAbstract:
The Human Activity Recognition (HAR) system allows various accessible entries for the early diagnosis of Diabetes as one of the nescient applications domains for the HAR. Long Short-Term Memory (LSTM) was applied and recognized 13 activities that resemble diabetes symptoms. Afterward, risk factor assessment for an experimental subject identified similar activity pattern attributes between diabetic patients and the experimental subject. Because of this, a trained LSTM model was deployed to monitor the average time length for every activity performed by the experimental subject for 30 consecutive days. Concurrently, the symptomatic diabetes activity patterns of diabetic patients were explored. The cosine similarity of activity patterns of the experimental subject and diabetic patients measured 57.39%, putting the experimental subject into moderate risk factor class. The experimental subject was clinically tested for risk factors using the diabetic clinical diagnosis process, known as the A1C. The A1C level was 6.1%, recognizing the experimental subject as a patient suffering from Diabetes. Thus, the proposed novel approach remarkably classifies the risk factor level based on activity patterns.
18
Mukhtar, Y., A. Galalain, and U. Yunusa. "A MODERN OVERVIEW ON DIABETES MELLITUS: A CHRONIC ENDOCRINE DISORDER." European Journal of Biology 5, no. 2 (November 23, 2020): 1–14. http://dx.doi.org/10.47672/ejb.409.
Full textAbstract:
Diabetes mellitus is one of the most common endocrine disorders that affect the body’s ability to make or use insulin. Diabetes mellitus (DM), or simply diabetes, is a group of chronic metabolic diseases in which a person experience high blood sugar, either because the pancreas does not produce enough insulin or because the body cells do not effectively use or respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). Conventionally, diabetes has been divided into three types namely: Type 1 DM or insulin-dependent diabetes mellitus (IDDM) in which body fails to produce insulin, and presently requires the person to inject insulin or wear an insulin pump. This is also termed as "juvenile diabetes". Type 2 DM or non-insulin-dependent diabetes mellitus (NIDDM), results from insulin resistance, a condition in which cells fail to use insulin properly, with or without an absolute insulin deficiency. This type was previously referred to as or "adult-onset diabetes". The third main type is gestational diabetes which occurs when women without a previous history of diabetes develop a high blood glucose level during her pregnancy and may metamorphose to type 2 DM after giving birth. Currently available pharmacotherapy for the treatment of diabetes mellitus includes insulin and oral hypoglycemic agents. Thus, the present review underscores the issues surrounding the symptoms, diagnosis and treatment (especially use of anti-diabetic herbal species) of this killer disease with a view to suppressing its global spread and resurgence.
19
Xie, Jiaying, Zhoujie Tong, Longfei Shen, Yuanyuan Shang, Yulin Li, Bin Lu, Weixuan Ma, Wei Zhang, and Ming Zhong. "Amylin: new insight into pathogenesis, diagnosis, and prognosis of non-insulin-dependent diabetes-mellitus-related cardiomyopathy." Emergency and Critical Care Medicine 2, no. 1 (January 27, 2022): 32–38. http://dx.doi.org/10.1097/ec9.0000000000000029.
Full text
20
Serio, Stephen, John M. Clements, Dawn Grauf, and Aziz M. Merchant. "Outcomes of Diabetic and Nondiabetic Patients Undergoing General and Vascular Surgery." ISRN Surgery 2013 (December 26, 2013): 1–9. http://dx.doi.org/10.1155/2013/963930.
Full textAbstract:
Aims. Preoperative diabetic and glycemic screening may or may not be cost effective. Although hyperglycemia is known to compromise surgical outcomes, the effect of a diabetic diagnosis on outcomes is poorly known. We examine the effect of diabetes on outcomes for general and vascular surgery patients. Methods. Data were collected from the Michigan Surgical Quality Collaborative for general or vascular surgery patients who had diabetes. Primary and secondary outcomes were 30-day mortality and 30-day overall morbidity, respectively. Binary logistic regression analysis was used to identify risk factors. Results. We identified 177,430 (89.9%) general surgery and 34,006 (16.1%) vascular surgery patients. Insulin and noninsulin diabetics accounted for 7.1% and 9.8%, respectively. Insulin and noninsulin dependent diabetics were not at increased risk for mortality. Diabetics are at a slight increased odds than non-diabetics for overall morbidity, and insulin dependent diabetics more so than non-insulin dependent. Ventilator dependence, 10% weight loss, emergent case, and ASA class were most predictive. Conclusions. Diabetics were not at increased risk for postoperative mortality. Insulin-dependent diabetics undergoing general or vascular surgery were at increased risk of overall 30-day morbidity. These data provide insight towards mitigating poor surgical outcomes in diabetic patients and the cost effectiveness of preoperative diabetic screening.
21
Sundaram, Ranjini K., Anusha Bhaskar, Selvamani Vijayalingam, Moopil Viswanathan, Rema Mohan, and Kalathinkal R. Shanmugasundaram. "Antioxidant Status and Lipid Peroxidation in Type II Diabetes Mellitus with and without Complications." Clinical Science 90, no. 4 (April 1, 1996): 255–60. http://dx.doi.org/10.1042/cs0900255.
Full textAbstract:
1. This study was conducted on 467 cases of non-insulin-dependent diabetes mellitus and 180 healthy controls. Lipid peroxidation products in plasma and erythrocytes were assayed as thiobarbituric acid reactive substances, along with the erythrocyte antioxidant enzymes, namely superoxide dismutase, catalase and glutathione peroxidase. In addition, scavenger vitamins A, C and E and reduced glutathione levels in blood were also measured. 2. Lipid peroxidation was significantly raised within the first 2 years of diagnosis, and superoxide dismutase, catalase, reduced glutathione and vitamins C and E were significantly lowered. 3. These changes were correlated with the duration of the disease and were of a higher magnitude with the development of complications. 4. The results suggest that the antioxidant deficiency and excessive peroxide-mediated damage may appear early on in non-insulin-dependent diabetes mellitus, before the development of secondary complications.
22
Naylor, RN, JT Montgomery, K. Lindauer, L. Letourneau, A. Bindal, M. Sanyoura, D. Carmody, SW Greeley, and LH Philipson. "ID: 23: LONG DELAY IN ACCURATE DIAGNOSIS OF HNF1A-MODY IN THE US MONOGENIC DIABETES REGISTRY." Journal of Investigative Medicine 64, no. 4 (March 22, 2016): 934.1–934. http://dx.doi.org/10.1136/jim-2016-000120.47.
Full textAbstract:
BackgroundMaturity-onset diabetes of the young (MODY) is autosomal dominant, young-onset, non-insulin dependent diabetes accounting for 2% of diabetes cases and up to 10% before age 35 years. It is frequently misclassified as type 1 or type 2 diabetes. Genetic testing for accurate diagnosis is important to guide therapy and management decisions, which are distinct for the common types of MODY, and identifies affected family members who can benefit from genetic testing. HNF1A-MODY is the most common form worldwide and responds to low doses of sulfonylureas with equivalent or improved glycemic control as compared to insulin therapy.AimHere we describe the US Monogenic Diabetes Registry HNF1A-MODY cohort, including phenotype, frequency and duration of diabetes misclassification, and treatment patterns.ResultsWe currently follow 47 probands and 74 individuals with HNF1A-MODY. Current mean age of probands and the entire cohort is 31.5 years and 33.2 years, respectively. Mean age at diabetes diagnosis was 16.9 years for probands and 18.0 years for the entire cohort. 89% of probands were diagnosed with diabetes <25 years. 76.9% of probands had normal BMIs at time of diagnosis. 82% had 2 or more affected generations with diabetes. Despite the large majority having classic features of MODY, on average, the duration of diabetes diagnosis prior to genetic diagnosis of MODY was 11.8 years. Of the 41 probands providing historical data on medications, 31 (75.6%) report previous use of insulin therapy. Of the 24 probands with current treatment data, 79% are on mono- or combination therapy with sulfonylureas or glinides.ConclusionsThe clinical features of MODY have been formally described since the early 1970s with gene causes discovered starting in 1992. However, MODY frequently goes unrecognized. In our cohort, most probands were misclassified for years prior to referral for genetic testing for accurate diagnosis. Sulfonylureas are the established first-line therapy for HNF1A-MODY. A large percentage of subjects were treated with insulin prior to diagnosis with subsequent initiation of sulfonylureas or other insulin secretagogues in 79% of those with current treatment data. The duration of diabetes misclassification coupled with frequent insulin use prior to accurate genetic diagnosis in our HNF1A-MODY cohort underscore the need to increase recognition of MODY among providers.
23
Umi Ahmad, Md. Idris Mohd Nor, and Osman Ali. "RISK FACTORS FOR DIABETIC NEPHROPATHY AMONG NON INSULIN DEPENDENT PATIENTS WHO ATTENDED CITY HALL'S STAFF CLINIC IN KUALA LUMPUR." Malaysian Journal of Public Health Medicine 1, no. 1 (June 1, 2001): 16–21. http://dx.doi.org/10.37268/mjphm/vol.1/no.1/art.1216.
Full textAbstract:
Diabetes mellitus and its main complication, nephropathy, affects the economic wellbeing and quality of life of the sufferers and the population. A matched case control study was conducted in September 1998 to investigate the factors involved with nephropathy such as diabetic control, smoking, hypertension, family history of diabetes and diabetic duration. Respondents were classified based on the presence of microalbuminuria or macroalbuminuria. Seventy-two pairs of case and control were studied. Duration of diabetes (p = 0.005), presence of lethargy and weakness prior to diabetes diagnosis (p = 0.019), duration of smoking (p = 0.014), duration of hypertension (p= 0.000), systolic hypertension (p= 0.025), uncontrolled diabetes with poor HbAlc level (p= 0.026) and lack of diabetes knowledge (p = 0.037) were factors which related significantly to nephropathy by univariate analysis. In multivariate analysis, systolic hypertension (p = 0.0015), lack of diabetes knowledge (p = 0.0197), presence of lethargy symptom (p = 0.0027), prolonged diabetic duration (p = 0.0301) and higher body mass indices ( p = 0.0213) were predictors to diabetic nephropathy.
24
Rahman, Md Hafizur, and Md Yusuf Ali. "Pancreatic Disorders and Diabetes Mellitus-A Review." Faridpur Medical College Journal 10, no. 1 (May 30, 2016): 36–39. http://dx.doi.org/10.3329/fmcj.v10i1.27924.
Full textAbstract:
Diabetes mellitus is a common disease among patients with pancreatic cancer and chronic pancreatitis. Hyperinsulinemia and peripheral insulin resistance are the prevailing diabetic traits in pancreatic cancer, whereas reduced islet cell mass and impaired insulin secretion are typically observed in chronic pancreatitis. Whether or not a causal relationship exists between diabetes and pancreatic carcinoma is an intriguing but unanswered question. Diabetes often precedes pancreatic cancer and is thus regarded as a potential risk factor for malignancy. Conversely, pancreatic cancer may secrete diabetogenic factors. Given these findings, there is increasing interest in whether close monitoring of the glycaemic profile may aid early detection of pancreatic tumor lesions. Exocrine pancreatic insufficiency is frequently associated with diabetes, with high prevalence in both insulin-dependent and insulinindependent patients. The incidence of diabetes caused by exocrine pancreatic disease appears to be underestimated and may comprise 8% or more of the general diabetic patient population. Non-endocrine pancreatic disease can cause diabetes by multiple mechanisms. Genetic defects have been characterized, resulting in a syndrome of both exocrine and endocrine failure. Regulation of beta cell mass and physiological incretin secretion are directly dependent on normal exocrine function. Algorithms for diagnosis and therapy of diabetes should therefore address both endocrine and exocrine pancreatic function.Faridpur Med. Coll. J. Jan 2015;10(1): 36-39
25
Niskanen, L., O. SIITONEN, J. KARJALAINEN, and M. UUSITUPA. "Hyperglycaemic symptoms before diagnosis of non-insulin-dependent (type 2) diabetes mellitus in relation to 5-year outcome." Journal of Internal Medicine 231, no. 4 (April 1992): 397–402. http://dx.doi.org/10.1111/j.1365-2796.1992.tb00950.x.
Full text
26
Nadra, Wissam E., Eric L. Knight, Martha B. Lee, and Woerner P. Meehan. "A Retrospective Study of Treatment Outcome for Patients With Non-Insulin-Dependent Diabetes at an Inner-City Hospital." Diabetes Educator 21, no. 2 (April 1995): 113–16. http://dx.doi.org/10.1177/014572179502100206.
Full textAbstract:
The medical records of 173 consecutive patients with diabetes who were newly enrolled in our facility in 1990 were analyzed for blood glucose at 1 year. A total of 81 females and 72 males with non-insulin-dependent diabetes were studied. With regard to overall compliance in keeping clinic appointments, 56 (36.6%) patients were still coming in for follow-up I year after the diagnosis of diabetes versus 97 (63.4%) patients who had stopped coming in. Overall, 70 (45.8%) patients had a plasma glucose > 180 mg/dL and had not achieved metabolic control, and 83 (54.2%) patients had a plasma glucose≤180 mg/dL and had achieved good metabolic control at their last visit. Most patients with good control (58/153, 69.9%) had stopped coming in by the end of 1 year. Only 25 patients with plasma glucose ≤180 mg/dL were still coming in for follow-up visits, representing the smallest percentage (16.3%) of the total population studied. At I year there also was a correlation between increased body weight and improved glycemic control.
27
Ruggenenti, P., V. Gambara, A. Perna, T. Bertani, and G. Remuzzi. "The nephropathy of non-insulin-dependent diabetes: predictors of outcome relative to diverse patterns of renal injury." Journal of the American Society of Nephrology 9, no. 12 (December 1998): 2336–43. http://dx.doi.org/10.1681/asn.v9122336.
Full textAbstract:
Nephropathy of non-insulin-dependent diabetes mellitus (NIDDM) is the most common cause of end-stage renal failure (ESRF) in Western countries. This study investigates the clinical and histologic putative predictors of disease progression, with the final goal to identify patients at risk who may benefit from early diagnosis and intervention. It examines by repeated measurements of BP, blood glucose, serum creatinine, and urinary protein excretion rate 65 consecutive NIDDM patients with clinical, persistent proteinuria and biopsy-documented typical diabetic glomerulopathy (class I; n = 30), predominant nephroangiosclerosis (class II; n = 23), or nondiabetic type glomerulopathy (class III; n = 12), whose severity of renal tissue involvement was precisely quantified by a global histologic score. Baseline parameters and progression to renal end points, i.e., doubling of baseline serum creatinine, dialysis, or transplantation, were univariately and multivariately correlated by proportional hazards regression models. The median kidney survival time in the overall study population was 3.07 yr. Thirty-seven percent of patients reached an end point during a median (range) follow-up of 1.8 yr (0.4 to 5.7 yr). By univariate and multivariate analysis, kidney survival significantly correlated with baseline urinary protein excretion rate (P = 0.04 and P = 0.04, respectively) and renal tissue injury score (P = 0.0001 and P = 0.02, respectively), but not with the histologic classes. Patients with a urinary protein excretion rate < or = 2 g/24 h, or > 2 g/24 h with a histologic score < 7, never reached an end point. All patients with urinary protein excretion > 2 g/24 h and a histologic score > 13 progressed to ESRF over a median of 1.6 yr. No differences in other baseline parameters or in BP and diabetes control during follow-up accounted for these different outcomes. In NIDDM as well as in nondiabetic chronic renal disease, quantification of urinary protein excretion rate--independent of the pattern of underlying glomerular involvement--reliably discriminates progressors from nonprogressors and, combined with precise quantification of renal tissue injury, reliably predicts risk of ESRF. This information may be used to set guidelines for early diagnosis and appropriate intervention to reduce the number of diabetic patients who will need renal replacement therapy in years to come.
28
Dreval, A. V., I. V. Misnikova, and Yu A. Redkin. "The degree of reliability of data obtained using a computer registry of patients with non-insulin-dependent diabetes mellitus." Problems of Endocrinology 45, no. 5 (October 15, 1999): 8–12. http://dx.doi.org/10.14341/probl11796.
Full textAbstract:
The main problem in analysis of the register of diabetes mellitus is evaluation of the reliability of data and the probability of extrapolating the results to a population of patients in the studied region. Our task was to assess the efficacy of diagnostic methods used in a region. Study of the prevalence of diabetic retinopathy and neuropathy by referent tests revealed poor sensitivity of methods for diagnosis of these complications in patients with insulin-dependent diabetes mellitus (IDDM) in the Mytischi region; hence, the prevalence of diabetic retinopathy and neuropathy might be higher than recorded in IDDM register.
Analysis confirmed the usefulness of active detection of early stages of complicated IDDM by screening (examination of the fundus oculi, detection of microalbuminuria and vibration sensitivity) for reflecting the true incidence of complications and timely therapy. Detection of numerous patients with IDDM at the phase of diabetes decompensation necessitates revision of preventive and therapeutic measures. High incidence of hypoglycemic reactions among IDDM patients necessitates their more active prevention, specifically, training IDDM patients to practice automonitoring methods.
29
de Toffol, B., P. Cotty, B. Gaymard, and S. Velut. "Progressive Necrosis of the Conus Medullaris: Magnetic Resonance Imaging and Surgical Findings." Neurosurgery 26, no. 1 (January 1, 1990): 147–49. http://dx.doi.org/10.1227/00006123-199001000-00024.
Full textAbstract:
Abstract A 67-year-old man with non-insulin-dependent diabetes mellitus progressively developed, over a 2-year period, lower extremity sensory and motor defects associated with impaired bladder function and perineal and perianal sensation related to a disease of the conus medullaris extending from T12 to S5. The magnetic resonance imaging scan suggested myelomalacia and the diagnosis of progressive necrotic myelopathy was confirmed by surgical intervention. (Neurosurgery 26:147-149, 1990)
30
Dreval, A. V., V. G. Vysotsky, T. A. Yatsyshina, O. A. Plotnikova, D. P. Tishin, N. V. V. Anykina, and О. I. Chernyak. "Indirect calorimetry in the differential diagnosis of the metabolic status of obese patients with non-insulin dependent diabetes mellitus." Problems of Endocrinology 39, no. 2 (April 15, 1993): 4–7. http://dx.doi.org/10.14341/probl11937.
Full textAbstract:
Twenty-one obese patients with non-insulin dependent diabetes mellitus, 16 female and 5 male ones, were led similar isocaloric rations, differing only by the share of substitution of the traditional protein products (0 %, 60 %, 30 %, 45 %) in the Danpro-S, Danpro-Fibre soybean protein concentrate. The parameters tested were daily glycemia, C-peptides, blood hydrocortisone, and urinary excretion of nitrous metabolites. Indirect calorimetry was used to assess the protein, fat, and carbohydrate oxidation rates at rest. Addition of proteins of a plant origin to the diets of such patients was associated with significant changes of the energy metabolism at rest at the expense of increased oxidation of carbohydrates and reduced protein catabolism, that may be regarded as a favorable effect. In this patient population a 30 % soybean diet brings about an almost maximal positive effect in patients with the first degree of obesity, whereas in those with the second degree of obesity such effect is attained by the 45 % soybean diet.
31
Boomsma, F., A. H. van den Meiracker, S. Winkel, H. J. Aanstoot, M. R. Batstra, A. J. Man in ’t Veld, and G. J. Bruining. "Circulating semicarbazide-sensitive amine oxidase is raised both in Type I (insulin-dependent), in Type II (non-insulin-dependent) diabetes mellitus and even in childhood Type I diabetes at first clinical diagnosis." Diabetologia 42, no. 2 (January 21, 1999): 233–37. http://dx.doi.org/10.1007/s001250051143.
Full text
32
Pankiv, V. I. "Epidemiology of diabetes mellitus." Problems of Endocrinology 41, no. 3 (June 15, 1995): 44–46. http://dx.doi.org/10.14341/probl11425.
Full textAbstract:
Diabetes mellitus (DM) is one of the most common diseases, the frequency of which is steadily increasing every year. In industrialized countries, the prevalence of DM is 4-5%. Despite the large number of existing forms of diabetes associated with various syndromes and diseases, the main ones are two that are characterized as spontaneous: insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes (NIDDM). Statistical data on the prevalence of the disease are based on the registration of a medical diagnosis of diabetes and in general reflect mainly the prevalence of spontaneous forms of IDDM and NIDDM. In 1991, 1 826 758 patients with DM were registered in the Russian Federation, of which 295 333 (16.2%) suffered from IDDM. Compared with 1990, the number of patients with diabetes increased by 5.78%. However, the figures do not reflect the actual prevalence of diabetes. The conducted epidemiological studies on the frequency of diabetes show that the true number of patients with diabetes is 3-4 times higher compared to the registered one. These include people with a mild form of NIDDM who do not need medical treatment, as well as people with impaired glucose tolerance. In these groups, disorders of carbohydrate metabolism occur in a subclinical form, and the recorded prevalence of diabetes is largely determined by the quality of the medical examination. A more accurate picture of the prevalence of various types of diabetes can be obtained only with the State Register for diabetes, its development is necessary in the near future.
33
Lukin, Pavel, Alex G. Kuchumov, Mikhail F. Zarivchatskiy, and Tatyana Kravtsova. "Clinical Classification of the Diabetic Foot Syndrome Adapted to ICD-10 as a Solution to the Problem of Diagnostics, Statistics and Standardisation." Medicina 57, no. 8 (August 11, 2021): 817. http://dx.doi.org/10.3390/medicina57080817.
Full textAbstract:
Background and Objectives: To propose a new classification of diabetic foot syndrome adapted for inclusion in the ICD-10 (the ICD-10 is the 10th revision of the International Statistical Classification of Diseases) and providing more reliable data on the number of clinical cases. Materials and Methods: A randomized controlled trial was performed. A total of 180 patients (36.6%) discharged from the hospital after surgical treatment and 312 patients (63.4%) who applied independently were observed and analysed. All patients had type 2 diabetes and were comparable in gender, age, duration of diabetes, area and nature of the wound defect. Results: We proposed to add the following to the existing ICD-10 and the emerging ICD-11 codes: Edf10.0—insulin-dependent diabetes mellitus with diabetic foot syndrome and Edf11.0—non-insulin-dependent diabetes mellitus with diabetic foot syndrome, where “df” is an acronym for diabetic foot. The new classification designates the seven most frequent areas of the lesion and five degrees of depth of soft tissue lesions. Conclusions: The proposed classification adapted for ICD-10 will enable the standardisation of diagnosis, providing a complete picture of this complication of diabetes mellitus, determining the number of amputations and their validity. Accurate statistics will allow for objective funding and timely preventive measures.
34
Heller, S. R., I. A. Macdonald, and R. B. Tattersall. "Counterregulation in Type 2 (non-insulin-dependent) diabetes mellitus. Normal endocrine and glycaemic responses, up to ten years after diagnosis." Diabetologia 30, no. 12 (December 1987): 924–29. http://dx.doi.org/10.1007/bf00295875.
Full text
35
Kondratiev, Y. Yu, V. V. Nosikov, and I. I. Dedov. "Polymorphic genetic markers and vascular complications of diabetes." Problems of Endocrinology 44, no. 1 (February 1, 1998): 43–51. http://dx.doi.org/10.14341/probl199844143-51.
Full textAbstract:
Diabetes mellitus is a clinically and genetically heterogeneous disease characterized by absolute or relative insulin deficiency and (or) peripheral tissue resistance to the hormone. Each of these disorders individually or in various combinations reduces tissue glucose consumption and increases the concentration of this monosaccharide in the patient’s blood. The state of hyperglycemia is a necessary and, over time, sufficient condition for the development of the so-called late complications of diabetes mellitus (mainly vascular - diabetic angiopathies). These chronic complications of diabetes are the main cause of high disability and mortality in patients, thus representing not only a serious medical and social, but also an economic problem [60]. This problem is exacerbated by the fact that recently there has been a tendency to an increase in the incidence of diabetes [42], the expected prevalence of which by 2010 will be about 215 million people [59]. In addition, the most common form of the disease, non-insulin-dependent (type II) diabetes mellitus (NIDDM), is characterized by delayed diagnosis and under-detection of the disease in the general population, leading to a significantly underestimated estimate of its prevalence [29, 30].
36
Dreval, A. V., I. V. Misnikova, Yu A. Redkin, L. B. Golubeva, and L. A. Shakhidova. "Epidemiological examination of the population of patients with non-insulin-dependent diabetes mellitus in the regions of the Moscow region (based on a computer registry)." Problems of Endocrinology 45, no. 3 (June 15, 1999): 3–7. http://dx.doi.org/10.14341/probl11757.
Full textAbstract:
Diabetes mellitus register in the Moscow region is created within the framework of the National Register of Russia in 1994. Two districts of the Moscow region served as the model for the register: the Mytischi district and the town of Roshal. The register of insulin-dependent diabetes mellitus (IDDM) includes 1542 patients. The prevalence of IDDM in the Mytischi district is 622.8, in Roshal 1828/100,000. IDDM of obesity is responsible for 33.1%) cases in Roshal and 44.6%) in the Mytischi district. A high percentage of IDDM patients have excessive body weight. The prevalence of late complications of diabetes is much higher in Roshal, where the percentage of patients with retinopathy is very high (89%). High incidence of retinopathy among patients with newly detected diabetes may be regarded as an evidence of late diagnosis of the disease. Collection of reliable information requires special training of endocrinologists, therapists, and other specialists involved in work with diabetes mellitus registers; they should be trained to fill in the information charts and use strictly determined classification of diabetes mellitus and its complications.
37
Shehzad, Sofia. "WORLD HEALTH DAY–DIABETES, A GROWING MENACE." Journal of Gandhara Medical and Dental Science 2, no. 2 (October 20, 2016): 1. http://dx.doi.org/10.37762/jgmds.2-2.230.
Full textAbstract:
World Health day, celebrated each year on 7th of April is all about creating awareness regarding health issues confronting the global population. The theme this year is Diabetes — a metabolic disorder of menacing proportion. There are a host of misconceptions and lack of understanding amongst the general public regards its exact etiology, prevention, control and socio-economic impact. As of 2015 the prevalence of the disease worldwide is estimated around 415 million affectees1. This number is expected to rise to 592 million by 2035 2. The incidence and resultant mortality secondary to this epidemic is on the rise in low and middle economy countries such as Pakistan, with the disease expected to be the 7th leading cause of death by 2030 3 . Diabetes occurs when the pancreas loses its ability to produce the required insulin or the body fails to utilize the later resulting in raised blood sugar levels 4. As a consequence, malfunctioning of various organ systems ensues and various life threatening illnesses including heart attacks, strokes, nerve damage, kidney failure, blindness, impotence and infections takes a toll on the patient's health. Broadly it is classified into 3 types - Type I or Insulin dependent diabetes mellitus also referred to as 'juvenile diabetes' in which the production of insulin is affected - Type II or Non insulin dependent diabetes mellitus characterized by insulin resistance, and having a strong correlation with increased body weight and lack of exercise 5. It is also called `adult onset 'diabetes'. - Gestational diabetes affecting pregnant women with no past history of the disease, usually in the 2Ild or 3rd trimester 6. The disease usually manifests with the symptoms of frequent urination, thirst and hunger. Once a diagnosis is made based on Blood sugar estimation and monitoring levels of glaciated hemoglobin - HbAl c, management ensues directed at achieving optimum level of blood glucose and avoiding systemic complications. This goal is achieved by introducing life style changes from a sedentary to more active and less stressful way of living, supplemented with a balanced diet and regular exercise. This is especially helpful in Type II DM. Treatment is offered by means of Oral hypoglycemic or injectable insulin as guided by the physician/endocrinologist. More recently bariatric Surgery has shown considerable promise as an effective measure to control blood sugar levels.7 This year the main objective of observing the world health day is to enhance awareness about prevention, care and surveillance of this disease. This will form the basis for launching the first ever global report on Diabetes. The core functions of WHO in this regard are as follows: - To frame internationally acceptable standards and guidelines for prevention, diagnosis and treatment of Diabetes and its associated complications - To closely monitor the morbidity and mortality associate with this disease. - Capacity building at different levels to address different aspects of this disease - To project diabetes as a global health issue and identify the population at risk Efforts to prevent and treat diabetes are essential to achieve the global sustainable development goal target of reducing premature mortality from non communicable diseases by one third by 2030. The community at large and the health care professionals and organizations in particular have a key role to play in highlighting the steps to be taken in this regard through organizing seminars and lectures and making use of the media to effectively communicate their message to the masses.Globalhealth dayfocusing onDiabetes certainlypromises tobe akeyeventin raising awareness andproposing effective measures supplementing themanagement of this disease ona globalstage.
38
Karimi, Mehran, Tahereh Zarei, Sezaneh Haghpanah, Azita Azarkeivan, Christos Kattamis, Vassilis Ladis, Yurdanur Kilinc, et al. "Evaluation of Endocrine Complications in Beta-Thalassemia Intermedia Patients: A Cross Sectional Multi-Center Study." Blood 132, Supplement 1 (November 29, 2018): 2343. http://dx.doi.org/10.1182/blood-2018-99-110903.
Full textAbstract:
Abstract The diagnosis of beta thalassemia intermedia (BTI) is mainly based on the severity of clinical phenotype. It is associated with a wide range of specific complications including extramedullary hematopoiesis, leg ulcers, gallstones, hypercoagulable state, pulmonary hypertension (PHT), endocrine disorders and osteoporosis. The commonest endocrine complication in beta thalassemia major (TM) patients is hypogonadism followed by hypothyroidism and diabetes but the data on endocrine disorders in BTI patients are scarce. The aim of this study is to determine the prevalence of endocrine complications in a large series of BTI patients. Methods: In this multi-countries cross-sectional study, all BTI patients registered at 12 thalassemic treatment centers in Iran (2 Centers), Italy (2 Centers), Greece, Turkey (2 centers), Oman, Qatar, Jordan, Cyprus and United Kingdom were enrolled during 2017. Non transfusion- dependent beta-thalassemia patients or those who received blood transfusion 3-4 times or less annually, were evaluated. Required information was collected from medical records using a designed questionnaire. Demographic data, clinical characteristics and laboratory data included age, sex, splenectomy, type of treatment (blood transfusion, iron chelation, hydroxyurea), hormonal assays, bone mineral density, calcium -phosphorous metabolism, serum ferritin, liver function tests, fetal and total hemoglobin levels,, platelet and nucleated red blood cell counts, were collected. Results: A total of 721 BTI patients were enrolled in the survey from 9 countries. The most prevalent disease-related complications were osteoporosis (21.6%) and hypogonadism (12.6%) followed by: central hypothyroidism (8.3%), non-insulin-dependent diabetes mellitus (7.8%), primary hypothyroidism (5.5%), insulin-dependent diabetes mellitus (4.2%), hypoparathyroidism (2.2%), growth hormone deficiency (1.1%), adrenal mass (1%) and thyroid cancer (0.5%). Conclusion: This study evaluated the largest cohort of BTI patients with endocrine disorders. Although BTI patients are non-transfusion dependent or only occasionally transfused, iron-overload due to increased intestinal iron absorption and enhanced bone marrow activity cause endocrine disorders and osteoporosis. This study demonstrate that although endocrine complications are less common in patients with BTI compared to data reported in literature in TM patients , a regular monitoring with timely diagnosis and proper management underscoring on osteoporosis and gonadal disorders are crucial to prevent endocrine complications in these patients. Disclosures No relevant conflicts of interest to declare.
39
Pimentel Muniz, Thiago, Daniel Vilarim Araujo, Kerry J. Savage, Tina Cheng, Moumita Saha, Xinni Song, Sabrina Gill, et al. "Pan-Canadian cohort of immune checkpoint inhibitor-induced insulin-dependent diabetes mellitus (CANDIED)." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 2640. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.2640.
Full textAbstract:
2640 Background: Endocrine immune-related adverse events (irAEs) are frequent with immune checkpoint inhibitors (ICIs); however, ICI-related insulin-dependent diabetes mellitus (IDDM) is a rare but serious endocrine irAE. We describe the characteristics of patients who developed ICI-related IDDM across five academic Canadian cancer centres. Methods: In this multicentre, retrospective study, we included both patients who developed IDDM and patients with non-IDDM (NIDDM) or pre-DM who became insulin-dependent while on treatment with ICI. We collected data on primary tumor type, ICI regimen (single agent or combination), time to development of IDDM from ICI initiation, comorbidities, laboratory parameters at the time of IDDM diagnosis, tumor response and survival. A p value < 0.05 was considered statistically significant. Results: We identified 27 patients between July 2016 and August 2019. Median age was 60 (39-79) years, 20 (74%) were male, 15 (55%) had melanoma and 4 each (15%) non-small cell lung cancer (NSCLC) and renal cell carcinoma. Seven (26%) patients had prior NIDDM or pre-DM; 5 (18%) had an auto-immune disease (2 psoriasis, 2 inflammatory bowel disease, and 1 systemic lupus erythematosus). Laboratory parameters at presentation and management of IDDM are presented in the Table. Mean A1c was not statistically different between patients with or without prior NIDDM or pre-DM (8.4% vs. 8.6%; p = 0.9). All IDDM events were irreversible; 1 (4%) patient died of diabetic ketoacidosis. At time of IDDM diagnosis, 17 (63%) patients were receiving single agent anti-PD1 and 10 (37%) anti-PD1-based combinations (7 anti-CTLA-4, and 3 other compounds). Median time for development of IDDM from ICI initiation was 2.7 months (95% CI 0.2-5.3). Patients receiving combination ICI developed IDDM earlier than those treated with single agent (1.4 vs 4.8 months; p = 0.05). Amongst patients with metastatic disease (n = 24), 9 (38%) had a complete response and 7 (29%) had a partial response. Two patients (8%) were treated in the adjuvant setting; 1 (4%) received consolidation ICI. IDDM led to ICI discontinuation in 12 (44%) patients. After a median follow up of 21 months from ICI initiation, median survival was 30 months (95% CI NE) and was not reached in patients with melanoma and NSCLC. Conclusions: ICI-related IDDM is a rare and typically irreversible irAE that occurs early in the course of treatment and develops earlier with combination ICI. In this cohort, patients who developed ICI-related IDDM had a high tumor response rate and prolonged survival, especially melanoma and NSCLC patients. Prospective evaluation of autoantibodies to predict development of IDDM is ongoing.[Table: see text]
40
Ozlu, Can, Gul Yesiltepe Mutlu, and Sukru Hatun. "A Turkish girl with H syndrome: stunted growth and development of autoimmune insulin dependent diabetes mellitus in the 6th year of diagnosis." Journal of Pediatric Endocrinology and Metabolism 32, no. 1 (January 28, 2019): 89–93. http://dx.doi.org/10.1515/jpem-2018-0380.
Full textAbstract:
Abstract Background H syndrome ([OMIM] 602782) is an autosomal recessive disorder with systemic manifestations and characteristic skin lesions, caused by mutations of the SLC29A3 gene. Short stature and diabetes mellitus are the major endocrine problems related to H syndrome, however, clear data from clinical follow-up of H syndrome patients is lacking in the literature. Case presentation Here, we present follow-up of a Turkish girl diagnosed with H syndrome at the age of 10 with a homozygous 310(c.933T>A, p.C310X) early stop codon mutation on exon 6 of the SLC29A3 gene. She had severe short stature non-responsive to growth hormone (GH) treatment and gluten-free diet despite low GH levels and celiac antibody positivity. She developed insulin dependent diabetes mellitus (IDDM) symptoms 6 years after the initial diagnosis. Conclusions H syndrome patients can develop IDDM years after characteristic symptoms. Short stature in H syndrome patients may not respond to GH replacement or gluten-free diet alone.
41
Baech, Joachim, Marianne Tang Severinsen, Andreas Kiesbye Øvlisen, Henrik Frederiksen, Peter Vestergaard, Christian Torp-Pedersen, Judit M. Jørgensen, et al. "Risk of Incident Diabetes and Dysregulated Pre-Existing Diabetes Mellitus in Newly Diagnosed Lymphoma Patients Treated with Steroid-Containing Immunochemotherapy: A Danish Population-Based Study." Blood 138, Supplement 1 (November 5, 2021): 454. http://dx.doi.org/10.1182/blood-2021-144733.
Full textAbstract:
Abstract Introduction Prednisolone has important potential side-effects, one of which is steroid-induced diabetes mellitus (DM). Due to the exposure to a high cumulative dosage of steroids during first-line treatment, patients with non-Hodgkin lymphoma (NHL) could face increased risk of new onset steroid-induced DM or dysregulation of a pre-existing DM. This nationwide observational cohort study evaluated the risk of new onset DM in lymphoma patients and the impact on pre-existing DM in lymphoma survivors following treatment with steroid-containing regimens. Methods Adult NHL patients (≥18 years) treated with ≥3 cycles of steroid-containing immunochemotherapy, such as R-CHOP(-like) and R-CVP, between 2002 and 2015 were identified in the Danish Lymphoma Register and matched to five random individuals from the general population on birth year, sex, Charlson Comorbidity Index score, baseline DM status (DM or not), and DM duration. NHL patients and matched comparators were followed from start of treatment for the patients until the event of interest (DM, insulin prescription), death, relapse, NHL diagnosis (for matched comparators), or censoring (emigration, missing, or end of study on 31 December 2018), whichever came first. DM was captured by either a diagnosis of any DM (ICD-10 codes: E10-E14) in the Danish National Patient Register or any redeemed anti-diabetic prescription registered in the National Prescription Register (insulin or oral anti-diabetic medicine; ATC A10A or A10B). In the analysis of insulin prescriptions following lymphoma treatment initiation, patients with any redeemed prescription of insulin prior to start of lymphoma treatment were excluded. Time-varying incidence rates (IRs) per 1,000 person years and incidence rate ratios (IRRs) with 95% confidence intervals were estimated using a spline-based Poisson regression approach with two-month time splits and five knots. The Aalen-Johansen estimator was used to compute the cumulative risk of an event treating death, relapse, and NHL diagnosis (in comparators) as competing events. Risk differences at specific time points were calculated using pseudo-observations. Crude and adjusted cause-specific hazard ratios (HR) were obtained using Cox regression. Results A total of 4,703 NHL patients were included in the present study. Median age was 66 years and median follow-up was 8.5 years. Among the NHL patients, 4,325 patients did not have pre-existing DM and were matched to 21,625 comparators without DM. The time-varying IR of DM among comparators was 8-10 cases/1000 person years. The IRR of DM for patients vs comparators was higher for patients in the first year following treatment initiation (maximum IRR: 2.40), lower from 1 to 5 years (minimum IRR: 0.52), and higher from 5 to 10 years (maximum IRR: 1.18) (Fig. 1). The cumulative incidence of DM was higher for NHL patients at six months (0.58 percentage units (%U), p <0.01), but lower at 5 years (-1.17%U, p <0.01) and 10 years (-2.09%U, p <0.01) compared to the matched comparators (p <0.01 for the whole period, Fig. 2). Among the NHL patients, 378 had pre-existing non-insulin dependent DM and were matched to 1,890 comparators. The cumulative incidence difference of any insulin use was higher for patients at 6 months (14.29%U, p <0.01), 5 years (9.95%U, p <0.01), and 10 years (4.61%U, p =0.15) (p <0.01 for the whole period, Fig. 3). However, when events were limited ≥5 prescriptions of insulin, no difference was found (p =0.84 for the whole period). The crude HR for ≥5 prescriptions of insulin was 1.42 [1.10;183] for patients compared to the matched comparators and the HR adjusted for sex, age, and comorbidities was 1.39 [1.08;1.79]. Conclusion In conclusion, patients treated with steroid-containing immunochemotherapy did not experience a higher risk of diabetes mellitus compared to matched comparators beyond the first year. Matched comparators had a higher cumulative incidence of diabetes mellitus after 2 years, which was partly explained by the high competing risk of death in the patient group. NHL patients with pre-existing non-insulin dependent diabetes mellitus had an increased cumulative incidence of any insulin prescriptions; however, the difference was diminished when assessing the risk of at least five insulin prescriptions, suggesting that the impact of steroids on diabetes regulation is limited in time when taking competing risks into account. Figure 1 Figure 1. Disclosures Øvlisen: Abbvie: Other: Travel expenses. Frederiksen: Abbvie: Research Funding; Gilead: Research Funding; Alexion: Research Funding; Novartis: Research Funding; Janssen Pharmaceuticals: Research Funding. Vestergaard: Novo Nordisk Foundation: Other: Head of Research at Steno Diabetes Center North Jutland funded by the Novo Nordisk Foundation, Research Funding. Jørgensen: Gilead: Consultancy; Novartis: Consultancy; Roche: Consultancy; Celgene: Consultancy. Clausen: Gilead: Consultancy, Other: Travel expences 15th ICML ; Abbvie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel expences ASH 2019; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees. Poulsen: Janssen: Consultancy; Abbvie: Consultancy. Ekstroem Smedby: Janssen Cilag: Research Funding; Takeda: Consultancy. Eloranta: Janssen Pharmaceutical NV: Other: NV. El-Galaly: ROCHE Ltd: Ended employment in the past 24 months; Abbvie: Other: Speakers fee.
42
Alchalabi, Halah, Ndausung Udongwo, Safa Albustani, Tasnuva Amin, Nusha Fareen, Praise Chineyemba, and Soemiwati Holland. "ODP264 An Unusual Etiology of Hypothyroidism and New-Onset Insulin-Dependent Diabetes: A Rare Side Effect of Opdivo." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A431. http://dx.doi.org/10.1210/jendso/bvac150.896.
Full textAbstract:
Abstract Introduction Nivolumab, a monoclonal antibody targeting programmed cell death 1 receptor, is prescribed for many advanced cancers like malignant melanoma, non-small cell lung cancer, renal cell carcinoma (RCC), etc. with increased use of this medication, the incidence of immune-related side effects is also on the rise. A combined medication side effect of new-onset diabetes and hypothyroidism associated with Nivolumab use is rare. We present a case of Nivolumab-induced hypothyroidism with new-onset insulin-dependent diabetes. Case presentation A 59-year-male with a past medical history of right RCC status post nephrectomy, non-ischemic cardiomyopathy with an ejection fraction of 25-30% on goal-directed therapy/implantable cardioverter-defibrillator, hypertension, hyperlipidemia, and chronic kidney disease stage 3 who presented to the emergency department with complaints of chest pain at rest. The pain was 5/10 in severity and non-radiating. It was relieved by sublingual nitroglycerine en route to the hospital. It was associated with fatigue, nausea, polyuria, and polyphagia. He denied any history of pre-diabetes/diabetes or thyroid disease. Of note, about six months prior to this admission, he was placed on nivolumab for his RCC. Vitals were BP 121/83, RR 20, HR 85, T 97.8°F, and 97% oxygen saturation on room air. The cardiopulmonary exam was unremarkable. An electrocardiogram showed sinus rhythm with normal rate and no ST/T wave changes. Troponin level was 0. 01 ng/mL (normal:: <0. 04 ng/mL) Chest x-ray revealed no acute pathology. Labs showed glucose of 1090 mg/dL (normal:: 70-100 mg/dL) and thyroid-stimulating hormone (TSH) of >50,000 IU/L (normal:: 0.3-4.2 IU/L). Urinalysis was positive for ketones; 20 mg/dL (normal:: negative). Venous blood revealed a pH level of 7.344. An acute coronary syndrome was ruled out, and he was admitted for management of hyperosmolar hyperglycemic state (HHS) and hypothyroidism. Due to a low level of C-peptide: <0.5 ng/mL (normal:: 1.1-4.4 ng/mL) and high TSH, a new-onset insulin-dependent autoimmune diabetes and hypothyroidism induced as a side effect of nivolumab was suspected. Nivolumab was discontinued from his medication regimen. Endocrinology was consulted for the management of HHS and hypothyroidism. Insulin drip and levothyroxine were started, and he was transferred to the intensive care unit for close monitoring. Thereafter, his metabolic derangements improved with the resolution of hyperglycemia and electrolyte disturbances. On discharge, his symptoms improved and he was advised to stop taking nivolumab. Discussion Nivolumab has been reported in the literature to cause worsening of glycemic control and is also rarely reported as a cause of insulin-dependent diabetes due to autoimmune effects. Its effects on the thyroid are usually reported as transient thyrotoxic period which either resolves to euthyroid or rarely hypothyroidism which is what happened with our patient. Recognizing the side effects of Nivolumab and periodic monitoring can help earlier diagnosis and management with better outcomes. Presentation: No date and time listed
43
Cosentino, Nicola. "Dyspnea in the emergency department at night." AboutOpen 4, no. 1 (September 28, 2018): 143–47. http://dx.doi.org/10.19156/abtpn.2018.0063.
Full textAbstract:
Acute pulmonary embolism (PE) interferes with both blood circulation and gas exchange. Right ventricular failure due to pressure overload is considered the leading cause of death by PE. The diagnosis of PE can be difficult, as the symptoms are often non-specific (dyspnea, chest pain, pre-syncope or syncope, hemoptysis). In particular, chest pain may be typical and derive from ischemia of the right ventricle: in these cases a differential diagnosis with acute coronary syndrome or with aortic dissection is necessary. If EP is suspected, it is therefore necessary to proceed promptly to the recommended diagnostic investigations. The case of a 62-year-old smoker suffering from arterial hypertension, dyslipidemia, non-insulin-dependent diabetes and chronic ischemic heart disease is reported here, admitted to emergency room for increasing dyspnea from mild stress in the absence of trauma, prolonged bed rest or fever. In suspicion of PE, CT angiography with contrast agent was performed for the study of the arterial tree, which confirmed the diagnosis of venous thromboembolism. The patient is treated with supporting tights, unfractionated heparin, and dabigatran is subsequently started (Cardiology).
44
Habib, Christopher, Matthew Gowan, Stefan Podgrabinski, Tom Grodski, Brenda Leung, Maria Shapoval, Dugald Seely, and Kieran Cooley. "Treating Type 2 Diabetes: A Cross-sectional Audit of Naturopathic Standards of Care Using the Naturopathic Patient Database." Journal of Evidence-Based Complementary & Alternative Medicine 17, no. 2 (March 22, 2012): 108–16. http://dx.doi.org/10.1177/2156587212438898.
Full textAbstract:
The Naturopathic Patient Database is a data management tool developed by the Canadian College of Naturopathic Medicine to collect patient data from its teaching clinic, the Robert Schad Naturopathic Clinic. This study investigated how type 2 diabetes mellitus was managed at the Robert Schad Naturopathic Clinic from May 2009 to February 2011. Cases of type 2 diabetes mellitus from the Robert Schad Naturopathic Clinic reported in the Naturopathic Patient Database were extracted based on an International Classification of Diseases, 10th revision code assessment of E11 (non-insulin-dependent diabetes mellitus) and files were audited. The American Diabetes Association 2010 standards of medical care in diabetes were used as guidelines for the audit. Multiple categories in diagnosis, physical exam, laboratory tests, and management were graded on a 0 to 2 scale. The average audit score was 55.5/90. The most common interventions being used are diet and aerobic exercise, followed by supplements (omega-3 fatty acids) and botanicals. These data suggest that the American Diabetes Association standards of care for type 2 diabetes mellitus are not followed stringently. Education and creation of a naturopathic standard of care may improve audit performance and patient outcomes.
45
Abdelmasih, Randa, Ramy Abdelmaseih, Faysal Rifai, Elio Paul Monsour, and Justin Reed. "SGLT2 Inhibitor Induced Euglycemic DKA (EDKA) With Proximal Renal Tubular Acidosis (RTA) as a Rare Fatal Complication in a Non-Insulin Dependent Diabetic Patient: A Challenging Dilemma." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A400—A401. http://dx.doi.org/10.1210/jendso/bvab048.815.
Full textAbstract:
Abstract Introduction: Diabetic Ketoacidosis (DKA) is characterized by a triad of hyperglycemia, acidemia, and ketonemia. Rarely, it would present with normal glucose levels making its diagnosis very challenging. The incidence of euglycemic DKA (eDKA) has increased with the introduction of the novel sodium-glucose cotransporter-2 inhibitors (SGLT2i). Currently, the reported incidence of SGLT2i induced DKA is 0.16–0.76 events per 1000 patient-years. We present a rare case of SGLT2i induced eDKA with proximal renal tubular acidosis (RTA). Case Presentation A 69 year-old male with type 2 diabetes mellitus presented to the hospital with severe respiratory distress, nausea and vomiting for 2 days. His home medications include metformin and canagliflozin. He was afebrile with respiratory rate 60 breaths/min. Arterial blood gas: pH 7.21, pCO2 9.2, pO2 223, HCO3 6. Blood glucose level was 120 mg/dl. Urinalysis was positive for large ketonuria >160 mg/dl and glycosuria >500 mg/dl. Serum anion gap and urine anion gap were elevated 29 mEq/L and 105 mEq/L respectively. Serum osmolarity and urine osmolality were elevated 296 mosm/kg and 653 mosm/kg respectively. Lactic acid was 5.3. Acetone was detected in blood. No source of infection was identified. Hemoglobin A1C was 5% and c-peptide was within normal range. Insulin and Islet cells antibodies were negative. DKA protocol was initiated until the anion gap closed. However, non-anion gap metabolic acidosis was persistent with profound hypophosphatemia. Repeat urinalysis showed glycosuria with pH ≤ 5.5, phosphaturia and generalized aminoaciduria. Ultimately, the patient elected to receive hospice care. Discussion: SGLT2i are currently recommended as second-line medications for type 2 diabetes mellitus. Their unique mechanism of action prevents glucose reabsorption from the proximal renal tubules. SGLT2i use is growing significantly, especially after recent clinical trials that demonstrated favorable protective effects. EDKA is precipitated by sepsis, acute illness, dehydration, or starvation. Once the diagnosis is suspected, SGLT2i should be stopped immediately. SGLT2i induced eDKA should be treated in a similar fashion as DKA. It is worth to note that SGLT2i half-life ranges from 11–17 hours, and despite drug discontinuation, glycosuria may persist for several days. What made our case unique and made the diagnosis challenging, was the normal blood glucose level, as well as other differentials that could have easily explained the acidosis including starvation ketosis and lactic acidosis. Also, the state of proximal RTA resembling renal Fanconi syndrome that occurred in correlation with canagliflozin therapy. To the best of our knowledge, this is the fourth reported case of proximal RTA with the use of canagliflozin resulting in life-threatening complications. The diagnosis was very challenging due to lack of awareness of this severe adverse effect.
46
Schweisberger, Cintya, Nila Palaniappan, Nicole Wood, Lauren Amos, and Kelsee Halpin. "Hyperglycemia Requiring Insulin Among Pediatric Patients Diagnosed With Hemophagocytic Lymphohistiocytosis." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A451—A452. http://dx.doi.org/10.1210/jendso/bvab048.922.
Full textAbstract:
Abstract Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disorder marked by massive cytokine release due to macrophage and T-cell activation. Hallmarks of the diagnosis include fever, splenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogemia, and elevations in ferritin and soluble IL-2 receptor. Given HLH is associated with critical illness, elevation in inflammatory markers, and treated with glucocorticoids, the development of hyperglycemia during its course is not unexpected. However, detailed descriptions of the severity of hyperglycemia and strategies in insulin management among HLH patients are lacking. We describe 10 years’ experience at a single tertiary pediatric health center with HLH patients who developed insulin dependent hyperglycemia. Objectives: To describe the demographics, clinical and laboratory findings, treatment regimens, and outcomes for children with HLH treated with insulin due to hyperglycemia. Study Design: Retrospective chart review from 2010 through 2019 of youth 0 to 21 years of age who required insulin therapy during or shortly after a hospitalization where they were diagnosed with HLH using established criteria. Descriptive statistics were used to characterize the population of interest. Results: Of 30 patients diagnosed with HLH, 33% (n=10) required insulin therapy. Half (n=5) were female and half (n=5) male. The mean age was 8.4 years (7.8 months - 17 years). The majority (80%) were non-Hispanic white. Mean BMI at admission was 53rd percentile (5th - 87th percentile). Max serum glucose ranged from 267 to 725 mg/dL (mean 421 mg/dL). Marked inflammation was present (max CRP 2.6 - 44.9 mg/dL, max ferritin 1,091 - 90,219 ng/mL). All were treated with dexamethasone, doses ranging from 5 to 11 mg/m2/day and duration from 2 to 70 days. Most (90%) received parenteral nutrition (PN) with a mean max GIR of 8 mg/kg/min (SD=2.7). Intravenous infusions of regular insulin were used in 80% of patients, though 2 patients were later transitioned to long and short acting subcutaneous insulin. Mean duration of IV insulin therapy was 9.5 days (2–24 days); however, 2 patients died while on IV insulin therapy. The majority (70%) needed insulin within 5 days of starting steroids. Two patients (20%) were treated with subcutaneous insulin only (no IV). Only 1 patient was discharged home on insulin therapy. Mean hospital stay was 60 days (10–202 days). Mortality was 50% (n=5). Conclusions: One-third of pediatric HLH patients required insulin during their hospitalization for severe hyperglycemia likely secondary to multiple factors including glucocorticoid use, parenteral nutrition, inflammation, and severe illness. Insulin is typically started within 5 days of initiating steroid therapy, limited to IV infusions, and often is not needed by the time of discharge. Risk of mortality is very high.
47
McPHILLIPS, JANICE BROWN, ELIZABETH BARRETT-CONNOR, and DEBORAH L. WINGARD. "CARDIOVASCULAR DISEASE RISK FACTORS PRIOR TO THE DIAGNOSIS OF IMPAIRED GLUCOSE TOLERANCE AND NON-INSULIN-DEPENDENT DIABETES MELLITUS IN A COMMUNITY OF OLDER ADULTS." American Journal of Epidemiology 131, no. 3 (March 1990): 443–53. http://dx.doi.org/10.1093/oxfordjournals.aje.a115519.
Full text
48
Sowattanangoon, Napaporn, Naipinich Kochabhakdi, and Keith J. Petrie. "Buddhist Values are Associated with Better Diabetes Control in Thai Patients." International Journal of Psychiatry in Medicine 38, no. 4 (December 2008): 481–91. http://dx.doi.org/10.2190/pm.38.4.g.
Full textAbstract:
Objectives: To examine the associations of Buddhist values with medication and dietary self-care, healthcare use, and glycosylated hemoglobin (HbA1c) level among Thai patients with a confirmed diagnosis of type 2 diabetes. Method: A total of 173 patients with non-insulin dependent diabetes mellitus were surveyed at two public hospitals in Bangkok. While waiting for doctors' appointments, the patients completed a questionnaire measuring Buddhist values and dietary and medication self-care activities. Doctor visits and HbA1c were taken from patient medical records. Results: Higher scores for Buddhist values were significantly correlated with better medication self-care ( r = .25, p = .001), better dietary self-care ( r =.21, p = .007), and more doctor visits in the previous 12 months ( r = .34, p = .0001). In a hierarchical regression analysis, stronger Buddhist values were significantly associated with a lower HbA1c, even after controlling for socio-demographic and dietary self-care ( R2 change = .03, F(1, 161) = 6.00, p = .015). Conclusions: Buddhist values may promote diabetes self-care among Thai patients. Further research is needed to evaluate the relationship of Buddhist values to diabetes-specific health behaviors and neuroendocrine outcomes.
49
Vähäsalo, Paula, Mikael Knip, Jukka Karjalainen, Eva Tuomilehto-Wolf, Raisa Lounamaa, Hans K. Åkerblom, and _. _. "Islet cell-specific autoantibodies in children with insulin-dependent diabetes mellitus and their siblings at clinical manifestation of the disease." European Journal of Endocrinology 135, no. 6 (December 1996): 689–95. http://dx.doi.org/10.1530/eje.0.1350689.
Full textAbstract:
Vähäsalo P, Knip M, Karjalainen J, Tuomilehto-Wolf E, Lounamaa R, Åkerblom HK, and the Childhood Diabetes in Finland Study Group. Islet cell-specific autoantibodies in children with insulin-dependent diabetes mellitus and their siblings at clinical manifestation of the disease. Eur J Endocrinol 1996;135:689–95. ISSN 0804–4643 The aim of this work was to characterize both newly diagnosed insulin-dependent diabetic subjects and their siblings with positive tests for islet cell-specific autoantibodies (ICSAA) and to evaluate whether there is an association between the ICSAA levels detected in the diabetic children and siblings. We analysed 781 probands younger than 15 years of age for islet cell antibodies (ICA) and 755 for insulin autoantibodies (IAA) and 610 of their 3–19-year-old non-diabetic siblings for ICA and IAA upon diagnosis of the proband. Islet cell antibodies were observed in 657 of the probands (84.1%) and IAA in 353 (46.8%). The ICA-positive probands were younger in age and had higher IAA levels than the ICA-negative probands, while the IAA-positive probands were younger and had higher levels of ICA than the IAA-negative probands. Islet cell antibodies were detected in 46 (7.5%) and IAA in 16 (2.6%) siblings, and the ICA-positive siblings had higher IAA levels than the ICA-negative siblings. A falling trend was seen in the frequency of ICA [2A7E] 20 Juvenile Diabetes Foundation units in the siblings with decreasing degrees of HLA identity with the index case. Infections during the preceding year, especially respiratory infections, increased the prevalence of both ICA and IAA in the diabetic children at diagnosis and the frequency of IAA in the siblings. There was a significant, although weak, correlation between the IAA levels of the probands and those of their siblings when 594 pairs were tested (rs = 0.15; p < 0.001). No association could be seen between the ICA levels of the probands and those of their siblings, not even when including only HLA-identical proband–sib pairs in the analysis. The lack of any relation between ICA levels in the probands and siblings supports the view that there may be multiple exogenous factors capable of inducing ICA formation or else a common factor but variable responsiveness in the index case and the sibling. Paula Vähäsalo, Department of Pediatrics, University of Oulu, FIN-90220 Oulu, Finland
50
Tkachuk, Vsevolod Arsen'evich, and Alexander Vyacheslavovich Vorotnikov. "Molecular Mechanisms of Insulin Resistance Development." Diabetes mellitus 17, no. 2 (May 29, 2014): 29–40. http://dx.doi.org/10.14341/dm2014229-40.
Full textAbstract:
Insulin resistance (IR) is a phenomenon associated with an impaired ability of insulin to stimulate glucose uptake by target cells and to reduce the blood glucose level. A response increase in insulin secretion by the pancreas and hyperinsulinemia are compensatory reactions of the body. The development of IR leads to the inability of target cells to respond to insulin that results in developing type 2 diabetes mellitus (T2DM) and metabolic syndrome. For this reason, the metabolic syndrome is defined in practice as a combination of IR with one or more pathologies such as T2DM, arterial hypertension, dyslipidemia, abdominal obesity, non-alcoholic fatty liver disease, and some others. However, a combination of high blood glucose and insulin levels always serves as its physiological criterion. IR should be considered as a systemic failure of the endocrine regulation in the body. Physiological causes of IR are diverse. The main ones are nutritional overload and accumulation of certain lipids and their metabolites in cells, low physical activity, chronic inflammation and stress of various nature, including oxidative and endoplasmic reticulum stress (impairment of damaged protein degradation in the cell). Recent studies have demonstrated that these physiological mechanisms likely act through a single intracellular scenario. This is the impairment of signal transduction from the insulin receptor to its targets via the negative feedback mechanism in intracellular insulin-dependent signaling cascades. This review describes the physiological and intracellular mechanisms of insulin action and focuses on their abnormalities upon IR development. Finally, feasible trends in early molecular diagnosis and therapy of IR are discussed.