Other Types of Diabetes

Question 1

Diabetes that occurs during the 2nd or 3rd trimester of pregnancy

Answer 1

Gestational Diabetes Mellitus

Question 2

Risks of Gestational Diabetes (in fetus and mother)

Answer 2

Fetus: large baby, hypoglycemia, NRDS
Mom: Caesarian deliveries, HTN, inc. risk for DM later in life

Question 3

Examples of Non-Type 1/2 Diabetes Mellitus

Answer 3

Gestational
Neonatal Diabetes
Maturity-Onset Diabetes of the Young (MODY)
Pancreatic disease (Cystic Fibrosis, Chronic Pancreatitis, tumors)
Drugs

Question 4

Example of “monogenic diabetes”; AD mutation in either glucokinase (glucose sensing) or insulin production; previously described as patients appearing to be Type 1 (young ADULTS and thin) BUT DID NOT progress to requiring insulin; have MILD fasting hyperglycemia, family pattern and respond to diet, exercise and oral meds

Answer 4

Maturity-Onset Diabetes of the Young

Question 5

Common defects in MODY

Answer 5

Glucokinase (impaired glucose sensing)
Transcription factors (impaired insulin production)

Question 6

Example of “monogenic diabetes” diagnosed <6 months of age; usually due to ACTIVATING mutations of Beta cell K+ channels, making them always OPEN, thus impairing Insulin release

Answer 6

Neonatal Diabetes

Question 7

MOA of Neonatal Diabetes

Answer 7

Activating mutation of Beta cell K+ channels–> always open–> impaired Insulin release

Question 8

How can Chronic Pancreatitis result in Diabetes?

Answer 8

Persistent destruction of pancreatic tissue and replacement with fibrosis; progress from exocrine to endocrine involvement gradually

Question 9

Chronic Pancreatitis usually affects the (exocrine/endocrine) parenchyma first

Answer 9

Exocrine

Question 10

Which Pancreatic Neuroendocrine tumors can result in HYPERglycemia

Answer 10

Glucagonoma

Somatostatinoma