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Author Question: Why do you think Matias was originally diagnosed with T2DM? Why does the MD now suspect he may ... (Read 46 times)

cnetterville

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Why do you think Matias was originally diagnosed with T2DM? Why does the MD now suspect he may actually have T1DM or LADA?
 
  What will be an ideal response?

Question 2

What are the standard diagnostic criteria for each of these diagnoses?
 
  What will be an ideal response?



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trampas

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Answer to Question 1

 He was diagnosed with type 2 diabetes one year ago due to hyperglycemia; there were probably no antibodies present at that time, meaning he met only the type 2 criteria.
 Now, the presence of antibodies GADA, IAA, and ICA indicates an autoimmune attack on the beta cells of the pancreas. The presence of antibodies makes a diagnosis of type 1 diabetes or LADA more appropriate.
 His c-peptide is 0.6, which is very low, indicating that very little insulin is being produced due to the auto-destruction of the beta cells, further confirming a type 1 diagnosis.

Answer to Question 2

Type 1 diabetes:
 Casual blood glucose above 200 mg/dL
 Fasting blood glucose above 126 mg/dL
 Oral glucose tolerance test >200 mg/dL (2-hr postprandial)
 Presence of antibodies ICA, GADA, IA-2A, and IAA
 Weight loss
 Polydipsia, polyuria, polyphagia
 C-peptide also used to help distinguish type 1 diabetes; low c-peptide indicates low or no insulin production
 HbA1c >6.5
Type 2 diabetes:
 Polydipsia, polyuria, polyphagia
 Casual blood glucose above 200 mg/dL
 Fasting blood glucose above 126 mg/dL
 Oral glucose tolerance test >200 mg/dL (2-hr postprandial)
 HbA1c >6.5
LADA: Generally, the most accepted diagnostic criteria for LADA includes the following: the presence of autoantibodies (e.g. ICA, GADA, and IA-2A), onset after age 30, and non-insulin dependent for at least six months past diagnosis




cnetterville

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Reply 2 on: Aug 21, 2018
Great answer, keep it coming :)


billybob123

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Reply 3 on: Yesterday
Gracias!

 

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