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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
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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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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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A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
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Atypical Diabetes and Management Considerations.

Shivajirao Prakash Patil1

  • 1Department of Family Medicine, Brody School of Medicine, East Carolina University, 101 Heart Drive, Mail Stop 654, Greenville, NC 278347, USA.

Primary Care
|May 20, 2022
PubMed
Summary

Accurate diabetes diagnosis is crucial, as misdiagnosis is common. Latent autoimmune diabetes in adults and ketosis-prone diabetes mellitus often require specific treatments, impacting patient care and outcomes.

Keywords:
Atypical diabetesKetosis-prone diabetes mellitus (KPDM)Latent autoimmune diabetes in adults (LADA)

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Area of Science:

  • Endocrinology
  • Immunology
  • Metabolic Diseases

Background:

  • Diabetes mellitus diagnosis can be challenging, with misdiagnosis occurring across all age groups.
  • Latent autoimmune diabetes in adults (LADA) and ketosis-prone diabetes mellitus (KPDM) present diagnostic complexities.
  • LADA shares features of type 1 and type 2 diabetes, often leading to misclassification as type 2.
  • KPDM is frequently misdiagnosed as type 1 diabetes.

Purpose of the Study:

  • To highlight the diagnostic challenges in differentiating various types of diabetes.
  • To emphasize the clinical implications of misdiagnosing LADA and KPDM.
  • To underscore the importance of accurate diagnosis for appropriate treatment initiation.

Main Methods:

  • Review of clinical presentations and diagnostic criteria for different diabetes types.
  • Analysis of immunogenetic and phenotypic characteristics of LADA and KPDM.
  • Comparison of diagnostic accuracy and treatment outcomes based on correct versus incorrect diagnoses.

Main Results:

  • Latent autoimmune diabetes in adults accounts for up to 12% of diabetes cases and is often misdiagnosed as type 2 diabetes.
  • Misdiagnosis of LADA can delay essential insulin therapy.
  • Ketosis-prone diabetes mellitus is frequently misidentified as type 1 diabetes.
  • Accurate diagnosis allows for de-escalation of insulin therapy and use of non-insulin agents when appropriate.

Conclusions:

  • Correctly identifying diabetes subtypes like LADA and KPDM is essential for effective management.
  • Timely and accurate diagnosis prevents treatment delays and optimizes therapeutic strategies.
  • Distinguishing between diabetes types ensures patients receive the most suitable treatment, potentially reducing reliance on insulin.