Difference between revisions of "Diabetes mellitus"

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'''Diabetes mellitus''', often (less precisely) just '''diabetes''', is a common affliction that is increasing the expanding waistlines.  It is commonly abbreviated '''DM'''.
[[Image:Main symptoms of diabetes.svg|thumb|right|350px|The manifestations of diabetes mellitus from a clinical perspective. (WC/Mikael Häggström)]]
'''Diabetes mellitus''', often just '''[[diabetes]]''', is a common affliction that is increasing with the expanding waistlines.  It is commonly abbreviated '''DM'''.


=General=
=General=
*Major cardiovascular risk factor.
*Major cardiovascular risk factor.
*Many subtypes.
*Many subtypes.
**Most common type 2, which is strongly assoc. with obesity.
**Most common: DM type 2 -- strongly associated with [[obesity]].


==Diagnosis==
==Diagnosis==
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==Classic complications==
==Classic complications==
Family medicine - mnemonic ''HELP'':
Family medicine - mnemonic ''HELP'':
*H - HbA1c, HTn.
*H - HbA1c, [[hypertension]].
*E - eye.
*E - [[eye]].
*L - lipids.
*L - lipids.
*P - podiatry, proteinuria, Pneumococcus vaccine.
*P - podiatry, proteinuria, Pneumococcus vaccine.
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==Emergency room presentations==
==Emergency room presentations==
*[[Ketoacidosis]] - DM type 1.
*[[Ketoacidosis]] - DM type 1.
*HONK - DM type 2.
*Hyperosmotic non-ketotic (HONK) coma - DM type 2.


=Subspecialty specific findings=
=Subspecialty specific findings=
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==Gastrointestinal pathology==
==Gastrointestinal pathology==
*[[Microscopic colitis]] - generally assoc. with autoimmune disorders.
*[[Microscopic colitis]] - generally assoc. with autoimmune disorders.
*[[Pancreas|Pancreatic]] [[amyloid]] deposition.<ref>URL: [http://www.umm.edu/altmed/articles/amyloidosis-000007.htm http://www.umm.edu/altmed/articles/amyloidosis-000007.htm]. Accessed on: 23 October 2010.</ref>
*[[Pancreas|Pancreatic]] [[amyloid]] deposition - in DM type 2.<ref>URL: [http://www.umm.edu/altmed/articles/amyloidosis-000007.htm http://www.umm.edu/altmed/articles/amyloidosis-000007.htm]. Accessed on: 23 October 2010.</ref>
*Centrilobular [[macrovescicular steatosis]] of the [[liver]].
*Centrilobular [[macrovescicular steatosis]] of the [[liver]].
*[[Pancreatic islet cell hyperplasia]] - in the fetus of a mother with diabetes.


==Breast pathology==
==Breast pathology==
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==Placental pathology==
==Placental pathology==
*[[Placentomegaly]].
*[[Placental villous immaturity]].
*[[Placental villous immaturity]].
*[[Chorangiosis]].<ref name=pmid20594143>{{cite journal |author=Amer HZ, Heller DS |title=Chorangioma and related vascular lesions of the placenta--a review |journal=Fetal Pediatr Pathol |volume=29 |issue=4 |pages=199–206 |year=2010 |pmid=20594143 |doi=10.3109/15513815.2010.487009 |url=}}</ref>
*[[Chorangiosis]].<ref name=pmid20594143>{{cite journal |author=Amer HZ, Heller DS |title=Chorangioma and related vascular lesions of the placenta--a review |journal=Fetal Pediatr Pathol |volume=29 |issue=4 |pages=199–206 |year=2010 |pmid=20594143 |doi=10.3109/15513815.2010.487009 |url=}}</ref>
*Two-vessel cord.<ref name=pmid7997408>{{cite journal |author=Lilja M |title=Infants with single umbilical artery studied in a national registry. 3: A case control study of risk factors |journal=Paediatr Perinat Epidemiol |volume=8 |issue=3 |pages=325–33 |year=1994 |month=July |pmid=7997408 |doi= |url=}}</ref>
*[[Two-vessel cord]].<ref name=pmid7997408>{{cite journal |author=Lilja M |title=Infants with single umbilical artery studied in a national registry. 3: A case control study of risk factors |journal=Paediatr Perinat Epidemiol |volume=8 |issue=3 |pages=325–33 |year=1994 |month=July |pmid=7997408 |doi= |url=}}</ref>


==Cardiovascular pathology==
==Cardiovascular pathology==
*[[Atherosclerosis]].
*[[Atherosclerosis]].
**[[Coronary artery disease]].
***[[Myocardial infarction]].
***[[Congestive heart failure]].
**[[Stroke]].
**[[Peripheral vascular disease]].
*[[Arterial hyaline]] - in both afferent and efferent arteriole of the [[kidney]].
*[[Arterial hyaline]] - in both afferent and efferent arteriole of the [[kidney]].


==Neuropathology==
==Neuropathology==
*Idiopathic inflammatory myositis.<ref name=pmid20536597>{{cite journal |author=Limaye VS, Lester S, Blumbergs P, Roberts-Thomson PJ |title=Idiopathic inflammatory myositis is associated with a high incidence of hypertension and diabetes mellitus |journal=Int J Rheum Dis |volume=13 |issue=2 |pages=132–7 |year=2010 |month=May |pmid=20536597 |doi=10.1111/j.1756-185X.2010.01470.x |url=}}</ref>
*Idiopathic inflammatory myositis.<ref name=pmid20536597>{{cite journal |author=Limaye VS, Lester S, Blumbergs P, Roberts-Thomson PJ |title=Idiopathic inflammatory myositis is associated with a high incidence of hypertension and diabetes mellitus |journal=Int J Rheum Dis |volume=13 |issue=2 |pages=132–7 |year=2010 |month=May |pmid=20536597 |doi=10.1111/j.1756-185X.2010.01470.x |url=}}</ref>
==Forensic pathology==
*Diabetic coma (preceding death) at [[autopsy]] - may be demonstrated with an elevated glucose in the vitreous fluid.<ref name=pmid19167848>{{Cite journal  | last1 = Zilg | first1 = B. | last2 = Alkass | first2 = K. | last3 = Berg | first3 = S. | last4 = Druid | first4 = H. | title = Postmortem identification of hyperglycemia. | journal = Forensic Sci Int | volume = 185 | issue = 1-3 | pages = 89-95 | month = Mar | year = 2009 | doi = 10.1016/j.forsciint.2008.12.017 | PMID = 19167848 }}</ref>


=References=
=References=
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[[Category:Clinical]]
[[Category:Clinical]]
[[Category:Diagnosis]]

Latest revision as of 06:02, 2 January 2016

The manifestations of diabetes mellitus from a clinical perspective. (WC/Mikael Häggström)

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

Breast pathology

Genitourinary pathology

Placental pathology

Cardiovascular pathology

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

  1. URL: http://www.umm.edu/altmed/articles/amyloidosis-000007.htm. Accessed on: 23 October 2010.
  2. 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.
  3. 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.
  4. 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.
  5. 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.