scholarly journals Atypical diabetes: a diagnostic challenge

2020 ◽  
Vol 8 (1) ◽  
pp. e001470
Author(s):  
Åke Sjöholm
Keyword(s):  
Type 2 Diabetes ◽  
Medical School ◽  
Precision Medicine ◽  
Clinical Characteristics ◽  
Diagnostic Challenge ◽  
Clinical Reality ◽  
Insulin Dependent ◽  
Elderly Onset ◽  
Atypical Diabetes

In medical school, we learned how to classify diabetes according to different clinical characteristics. However, at the dawn of the precision medicine era, it is clear that today’s clinical reality does not always align well with textbook teachings. The terms juvenile versus elderly-onset diabetes, as well as insulin-dependent versus non-insulin-dependent diabetes, have become obsolete. Contrary to what is often taught severe ketoacidosis may occur in type 2 diabetes. Patients may also suffer from two or more forms of diabetes simultaneously or consecutively. Five authentic cases of diabetes with uncommon characteristics that pose diagnostic challenges are presented here.

scholarly journals Abnormal echocardiography in patients with type 2 diabetes and relation to symptoms and clinical characteristics

2016 ◽  
Vol 13 (5) ◽  
pp. 321-330 ◽  
Author(s):  
Peter Godsk Jørgensen ◽  
Magnus T Jensen ◽  
Rasmus Mogelvang ◽  
Bernt Johan von Scholten ◽  
Jan Bech ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Characteristics

Diabetic neuropathy: Epidemiological, pathogenetic, and clinical aspects with special emphasis on type 2 diabetes mellitus

1983 ◽  
Vol 104 (4_Suppl) ◽  
pp. S89-S94
Author(s):  
E. Matikainen ◽  
J. Juntunen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Control ◽  
Clinical Aspects ◽  
Type 2 Diabetics ◽  
Insulin Dependent

ABSTRACT. Peripheral neuropathy is a frequent complication of diabetes mellitus. Alterations of the peripheral nervous system in diabetics have been studied in numerous investigations. There are many factors known to participate in the development of this complication, e.g. the age of the patient, duration of the diabetes, quality of the diabetic control etc. The role of different types of diabetes in development of neuropathy is still largely unclear since investigations on this aspect are few. It seems, however, that peripheral neuropathy in type 2 (non-insulin dependent) diabetes is common but often mild. The differential diagnosis of the peripheral neuropathy in type 2 diabetics is more difficult than in type 1 (insulin dependent) diabetics, since these patients tend to be older and also may have other concomitant disorders. In this paper the clinical features and pathogenetic mechanisms of neuropathy in type 2 diabetes are briefly discussed.

scholarly journals Clinical Characteristics and Risk of Diabetic Complications in Data-Driven Clusters Among Type 2 Diabetes

2021 ◽  
Vol 12 ◽  
Author(s):  
Lin Xing ◽  
Fangyu Peng ◽  
Qian Liang ◽  
Xiaoshuang Dai ◽  
Junli Ren ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Complications ◽  
Clinical Characteristics ◽  
Chinese Patients ◽  
Newly Diagnosed ◽  
Medication Treatment ◽  
Dipeptidyl Peptidase 4 ◽  
Age Related

BackgroundThis study aimed to cluster newly diagnosed patients and patients with long-term diabetes and to explore the clinical characteristics, risk of diabetes complications, and medication treatment related to each cluster.Research Design and MethodsK-means clustering analysis was performed on 1,060 Chinese patients with type 2 diabetes based on five variables (HbA1c, age at diagnosis, BMI, HOMA2-IR, and HOMA2-B). The clinical features, risk of diabetic complications, and the utilization of elven types of medications agents related to each cluster were evaluated with the chi-square test and the Tukey–Kramer method.ResultsFour replicable clusters were identified, severe insulin-resistant diabetes (SIRD), severe insulin-deficient diabetes (SIDD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD). In terms of clinical characteristics, there were significant differences in blood pressure, renal function, and lipids among clusters. Furthermore, individuals in SIRD had the highest prevalence of stages 2 and 3 chronic kidney disease (CKD) (57%) and diabetic peripheral neuropathy (DPN) (67%), while individuals in SIDD had the highest risk of diabetic retinopathy (32%), albuminuria (31%) and lower extremity arterial disease (LEAD) (13%). Additionally, the difference in medication treatment of clusters were observed in metformin (p = 0.012), α-glucosidase inhibitor (AGI) (p = 0.006), dipeptidyl peptidase 4 inhibitor (DPP-4) (p = 0.017), glucagon-like peptide-1 (GLP-1) (p <0.001), insulin (p <0.001), and statins (p = 0.006).ConclusionsThe newly diagnosed patients and patients with long-term diabetes can be consistently clustered into featured clusters. Each cluster had significantly different patient characteristics, risk of diabetic complications, and medication treatment.

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