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Diabetes mellitus in the young in Srinagarind Hospital
S Kiatsayompoo1, W Lueprasitsakul, P Bhuripanyo
1Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
Insights
This study on young diabetes cases found malnutrition-related diabetes mellitus (MRDM) is common, often linked to farming and abdominal pain. Pancreatic calcification was observed in a third of MRDM patients.
Area of Science:
- Endocrinology
- Diabetology
- Public Health
Background:
- Diabetes mellitus in young individuals (<35 years) presents diverse etiological classifications.
- Malnutrition-related diabetes mellitus (MRDM) is a significant subtype requiring further characterization.
- Understanding the distinct features of diabetes subtypes is crucial for targeted interventions.
Purpose of the Study:
- To classify diabetes cases in young individuals based on established etiological categories.
- To investigate the clinical and epidemiological characteristics differentiating MRDM from other diabetes types (NIDDM, IDDM).
- To identify risk factors and associated conditions in young-onset diabetes, particularly within the MRDM group.
Main Methods:
- Retrospective analysis of 151 diabetes cases in individuals aged 35 years or younger.
- Classification of diabetes into non-insulin dependent diabetes mellitus (NIDDM), MRDM, insulin-dependent diabetes mellitus (IDDM), and other categories.
- Abdominal roentgenography to detect pancreatic calcification in a subset of patients.
- Statistical comparison of demographic, clinical, and occupational factors between MRDM and other diabetes groups.
Main Results:
- MRDM constituted 36.4% of young diabetes cases, with fibrocalculous (22.5%) and protein-deficient (13.9%) subtypes identified.
- Pancreatic calcification was found in 33% of MRDM patients who underwent abdominal roentgenography.
- Farming occupation, abdominal pain, male sex, and cataracts were significantly more prevalent in MRDM compared to NIDDM and IDDM combined.
- No significant differences in alcohol consumption or raw cassava intake were noted between MRDM and other groups.
Conclusions:
- MRDM is a substantial subtype of diabetes in the young, associated with specific clinical and occupational factors.
- The high prevalence of pancreatic calcification in MRDM suggests a link to pancreatic pathology.
- Targeted public health strategies addressing occupational risks and nutritional factors may be beneficial for preventing and managing MRDM in young populations.
Abstract:
We studies 151 case of diabetes in the young (age at first visit < or = 35 yrs) from January 1982 to June 1990. We classified the 151 cases into non-insulin dependent diabetes mellitus (NIDDM) (38.4%), malnutrition-related diabetes mellitus (MRDM) (36.4%), insulin-dependent diabetes mellitus (IDDM) (9.9%), secondary diabetes mellitus (2.6%) and unclassified category (12.6%). MRDM can be further classified into 2 groups: 22.5 per cent were fibrocalculous pancreatic diabetes (FCPD) and 13.9 per cent were protein deficient pancreatic diabetes (PDPD). Abdominal roentgenography were performed in 103 cases (68.2%) and pancreatic calcification were found in 34/103 (33%). Farming occupation (p = 0.001), abdominal pain (p = 0.005), male sex (p = 0.0015) and cataracts (p = 0.02) were statistically more common in MRDM comparing to NIDDM and IDDM taken together. There were no statistically significant differences in history of alcohol consumption and raw cassava intake between both groups. Family history of diabetes mellitus were more common in NIDDM comparing to IDDM and MRDM.