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Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

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Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated...
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Type II Diabetes II: Pathophysiology01:24

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PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
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Type I Diabetes II: Pathophysiology01:26

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Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular...
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Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the...
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Hyperglycemia01:29

Hyperglycemia

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Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose...
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Diabetes: Symptoms, Diagnosis, and Complications01:15

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Prediabetes, elevated iron and all-cause mortality: a cohort study.

Arch G Mainous1, Rebecca J Tanner2, Thomas D Coates3

  • 1Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida, USA Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA.

BMJ Open
|December 16, 2014
PubMed
Summary

Prediabetes alone has a low mortality risk. However, elevated iron markers, especially transferrin saturation (TS), significantly increase mortality risk in individuals with prediabetes.

Keywords:
DIABETES & ENDOCRINOLOGYHAEMATOLOGY

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Area of Science:

  • Endocrinology
  • Public Health
  • Nutritional Science

Background:

  • Prediabetes is associated with minimal mortality risk.
  • The impact of elevated iron markers on prediabetes mortality remains unclear.

Purpose of the Study:

  • To investigate the mortality risk in adults with prediabetes and coexisting elevated iron markers.
  • To determine if elevated transferrin saturation (TS) or serum ferritin impacts mortality in prediabetic individuals.

Main Methods:

  • Utilized data from the National Health and Nutrition Examination Survey (NHANES III) (1988-1994) and National Death Index (1988-2006).
  • Included US adults aged 40 and older with available blood samples.
  • All-cause mortality was the primary outcome measure.

Main Results:

  • Prediabetes showed a small increase in all-cause mortality risk (HR=1.04).
  • Individuals with prediabetes and elevated serum ferritin had a higher mortality risk (HR=1.14).
  • Prediabetic individuals with elevated transferrin saturation (TS) exhibited a substantially increased mortality risk (HR=1.88).

Conclusions:

  • The mortality risk associated with prediabetes is generally low.
  • Elevated iron markers, particularly transferrin saturation (TS), significantly elevate mortality risk in the prediabetic population.