Diabetes mellitus
Diabetes mellitus, often just diabetes, is a common affliction that is increasing with the expanding waistlines. It is commonly abbreviated DM.
General
- Major cardiovascular risk factor.
- Many subtypes.
- Most common: DM type 2 -- strongly associated with obesity.
Diagnosis
Based on biochemistry, specifically:
- Fasting blood glucose >=7.0 mmol/L.
- Two-hour glucose tolerance test >=11.1 mmol/L.
Classic complications
Family medicine - mnemonic HELP:
- H - HbA1c, hypertension.
- E - eye.
- L - lipids.
- P - podiatry, proteinuria, Pneumococcus vaccine.
Emergency room presentations
- Ketoacidosis - DM type 1.
- Hyperosmotic non-ketotic (HONK) coma - DM type 2.
Subspecialty specific findings
Dermatopathology
Other:
Gastrointestinal pathology
- Microscopic colitis - generally assoc. with autoimmune disorders.
- Pancreatic amyloid deposition - in DM type 2.[1]
- Centrilobular macrovescicular steatosis of the liver.
- Pancreatic islet cell hyperplasia - in the fetus of a mother with diabetes.
Breast pathology
Genitourinary pathology
Placental pathology
Cardiovascular pathology
- Atherosclerosis.
- Arterial hyaline - in both afferent and efferent arteriole of the kidney.
Neuropathology
- Idiopathic inflammatory myositis.[4]
Forensic pathology
- Diabetic coma (preceding death) at autopsy - may be demonstrated with an elevated glucose in the vitreous fluid.[5]
References
- ↑ URL: http://www.umm.edu/altmed/articles/amyloidosis-000007.htm. Accessed on: 23 October 2010.
- ↑ Amer HZ, Heller DS (2010). "Chorangioma and related vascular lesions of the placenta--a review". Fetal Pediatr Pathol 29 (4): 199–206. doi:10.3109/15513815.2010.487009. PMID 20594143.
- ↑ Lilja M (July 1994). "Infants with single umbilical artery studied in a national registry. 3: A case control study of risk factors". Paediatr Perinat Epidemiol 8 (3): 325–33. PMID 7997408.
- ↑ Limaye VS, Lester S, Blumbergs P, Roberts-Thomson PJ (May 2010). "Idiopathic inflammatory myositis is associated with a high incidence of hypertension and diabetes mellitus". Int J Rheum Dis 13 (2): 132–7. doi:10.1111/j.1756-185X.2010.01470.x. PMID 20536597.
- ↑ Zilg, B.; Alkass, K.; Berg, S.; Druid, H. (Mar 2009). "Postmortem identification of hyperglycemia.". Forensic Sci Int 185 (1-3): 89-95. doi:10.1016/j.forsciint.2008.12.017. PMID 19167848.