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Diabetes Mellitus: Overview and Type I Subtype01:22

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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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Pathophysiology of Diabetes01:20

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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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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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Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Insulin: Dosing Regimen and Adverse Effects01:16

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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
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Bioluminescent Monitoring of Graft Survival in an Adoptive Transfer Model of Autoimmune Diabetes in Mice
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Autoimmune diabetes insipidus.

Werner A Scherbaum1

  • 1Department of Endocrinology, Heinrich-Heine-University, Duesseldorf, Germany.

Handbook of Clinical Neurology
|July 9, 2021
PubMed
Summary
This summary is machine-generated.

Autoimmune central diabetes insipidus (CDI) is caused by autoantibodies targeting rabphilin-3A. Lymphocytic infundibuloneurohypophysitis (LINH) is the key pathological finding in autoimmune CDI.

Keywords:
AutoantibodiesCentral diabetes insipidusImmune checkpoint inhibitorsLymphocytic infundibuloneurohypophysitisRabphilin-3AVasopressin

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Electrochemiluminescence Assays for Human Islet Autoantibodies
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Area of Science:

  • Endocrinology
  • Immunology
  • Neuroscience

Background:

  • Central diabetes insipidus (CDI) diagnosis requires identifying underlying causes.
  • Autoimmune etiology is a key consideration in idiopathic CDI and sellar mass lesions.
  • Autoantibodies to vasopressin-producing cells (AVPcAb) were first detected in 1983.

Purpose of the Study:

  • To highlight autoimmune CDI as a distinct diagnosis.
  • To identify the major autoantigen in autoimmune CDI.
  • To correlate autoimmune CDI with specific radiological and pathological findings.

Main Methods:

  • Detection of autoantibodies to hypothalamic vasopressin-producing cells (AVPcAb) via indirect immunofluorescence.
  • Identification of autoantibodies to rabphilin-3A using Western blotting.
  • Magnetic resonance imaging (MRI) and biopsy for lymphocytic infundibuloneurohypophysitis (LINH) diagnosis.

Main Results:

  • Rabphilin-3A is identified as the major autoantigen in autoimmune CDI.
  • Detection of autoantibodies to rabphilin-3A or AVPcAb strongly supports autoimmune CDI diagnosis.
  • Lymphocytic infundibuloneurohypophysitis (LINH), characterized by immune cell infiltration, is the pathological correlate of autoimmune CDI.

Conclusions:

  • Autoimmune CDI is a significant diagnosis, often associated with other autoimmune endocrine disorders.
  • Rabphilin-3A autoantibodies and LINH are key diagnostic markers for autoimmune CDI.
  • LINH can occur spontaneously or secondary to immune checkpoint inhibitor therapy.