PURPOSE: It is well known that linear growth in diabetic children is closely related to metabolic control and age of onset. Some studies showed growth retardation in diabetic children regardless of the degree of metabolic control, whereas others reported no growth impairment. Until now, no study has been done comparing linear growth between type 1 and type 2 diabetic children. Therefore, we compared the growth and weight status between type 1 and type 2 diabetic children. METHODS: 145 children with type 1 DM and 27 patients with type 2 DM were studied. Their growth status in height standard deviation score(HTSDS), obesity according to standard weight for height and body mass index(BMI), and HbA1c level at onset, 6 months, 1 year, 3 years and 5 years after treatment were compared. RESULTS: There was no distinct correlation in HTSDS in type 1 and type 2 DM, but in type 2 DM obesity according to standard weight for height and BMI was higher than in type 1 DM. deltaHTSDS 5 years after treatment of diabetic children with poor glycemic control were significantly decreased(P<0.05), but there was no significant correlation between HbA1c and obesity according to standard weight for height and BMI. CONCLUSION: There is no significant correlation between the type of diabetes and growth status, but the poor glycemic controled group showed a significant decrease in deltaHTSDS. These data suggest that the growth of diabetic children could be impaired in the case of poor glycemic control and long duration of diabetes.
Age of Onset ; Child ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Humans ; Obesity

Posttransplant diabetes mellitus, a complication due to corticosteroids and the calcineurin inhibitors, cyclosporine and tacrolimus, is commonly regarded as a form of type 2 diabetes mellitus. Diabetes ketoacidosis, which requires relative insulin deficiency to impair fatty acid metabolism, is a complication of type 1 diabetes mellitus. We report two patients who presented with diabetic ketoacidosis after kidney transplantation. Two patients presented with severe hyperglycemia, significant ketosis and metabolic acidosis of variable severity. One patient was treated with a cyclosporine-based regimen, and the other with a tacrolimus-based regimen. Both were found to have moderate to high serum levels of calcineurin inhibitors on presentation. Our experience suggests that post-transplant diabetes mellitus, in association with calcineurin inhibitor, may result in ketoacidosis either secondary to relative beta cell dysfunction, peripheral insulin resistance, or a combination of the two effects. Post transplant diabetes mellitus can be an atypical form of adult-onset diabetes with features of both type 1 and type 2 diabetes mellitus.
Acidosis ; Adrenal Cortex Hormones ; Calcineurin ; Cyclosporine ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Diabetic Ketoacidosis ; Humans ; Hyperglycemia ; Insulin ; Insulin Resistance ; Ketosis ; Kidney Transplantation ; Metabolism ; Tacrolimus

Hemichorea-hemiballism is a rare complication of nonketotic hyperglycemia in type 2 diabetes mellitus (T2DM). It can be complicated in long-standing type 1 diabetes mellitus or T2DM, and has been described as a presenting symptom of new-onset diabetes. Rapid correction of diabetic ketoacidosis may also cause the delayed hemichorea. Although hyperglycemic hemiballism rarely causes generalized chorea due to bilateral basal ganglia involvement, patients typically present with hemichorea developing over days to months in the setting of elevated serum glucose. On T1-weighted brain magnetic resonance imaging and computed tomography scan a high signal intensity lesion at the basal ganglia is characteristic. After the correction of hyperglycemia, the movements generally disappear within hours, but atypical cases with delayed onset after the resolution of hyperglycemia, unremitting severe movements, and late recurrence are also reported. We report two cases of female T2DM patients who presented with hemichorea. One patient presented with hemichorea in nonketotic hyperglycemia, and the other with delayed onset hemichorea after the resolution of hyperglycemia.
Basal Ganglia ; Brain ; Chorea ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Diabetic Ketoacidosis ; Dyskinesias ; Female ; Glucose ; Humans ; Hyperglycemia ; Magnetic Resonance Imaging ; Recurrence

No abstract available.
Chronic Periodontitis* ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Humans* ; Tissue Inhibitor of Metalloproteinase-1

This review describes the epidemiology of childhood diabetes in India. It focuses on the incidence and prevalence of type 1 diabetes and its complications and comorbid conditions. The review also covers data related to type 2 diabetes, glucose intolerance, and monogenic diabetes from India. A brief discussion regarding unique contributions from India to the world literature is included. The topics discussed include use of camel milk as adjuvant therapy in type 1 diabetes, relevance of the A1/A2 hypothesis, and comprehensive clinico-etiopathological classification of type 1 diabetes.
Camels ; Child ; Classification ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Epidemiology ; Glucose Intolerance ; Humans ; Incidence ; India* ; Milk ; Prevalence

Infantile onset diabetes mellitus(especially, neonatal diabetes) is rare disorder and may be transient or permanent. Most patients are full-term but small-for-date infants and typical symptoms occur within the first 4-6 weeks of life, requiring insulin therapy. Neonatal diabetes differs from type 1 diabetes in many aspects and seems to form a distinct entity of inborn pancreatic malfunction. The transient cases often develop type 2 diabetes mellitus later in life. In recent reports, transient neonatal diabetes is associated with paternal uniparental isodisomy and unbalanced duplication of chromosome 6q22-23. In our study, clinical course of case 1 was compatible with transient neonatal diabetes, but chromosomal abnormalities such as above was not shown in DNA analysis. In case 2 and 3, we could not decide exactly on genetic basis.
Chromosome Aberrations ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; DNA ; Genomic Imprinting ; Humans ; Infant ; Insulin ; Uniparental Disomy

PURPOSE: Serum glycated albumin (GA) has been recently used as another glycemic marker that reflects shorter term glycemic control than glycated hemoglobin (HbA1c). Insulin secretory function and glycemic fluctuation might be correlated with the ratio of GA to HbA1c (GA/HbA1c) in diabetic adult patients. This study investigated the association of GA and GA/HbA1c ratio with the levels of fasting C-peptide, fasting plasma glucose in type 1 and type 2 pediatric diabetes. METHODS: Total 50 cases from 42 patients were included. The subjects were classified into type 1 diabetes mellitus (T1DM) (n=30) and type 2 diabetes mellitus (T2DM) (n=20) group. The associations among HbA1c, GA, and GA/HbA1c ratio were examined. The relationship between the three glycemic indices and fasting glucose, fasting C-peptide were analyzed. RESULTS: Mean values of GA, the GA/HbA1c ratio were significantly higher in T1DM than T2DM. GA (r=0.532, P=0.001), HbA1c (r=0.519, P=0.002) and the GA/HbA1c ratio (r=0.409, P=0.016) were correlated with the fasting plasma glucose. Fasting C-peptide level arranged 4.22+/-3.22 ng/mL in T2DM, which was significantly above the values in T1DM (0.26+/-0.49 ng/mL). There were no significant correlation between HbA1c and fasting C-peptide level. However, GA and the GA/HbA1c ratio exhibited inverse correlations with fasting C-peptide level (r=-0.214, P=0.002; r=-0.516, P<0.001). CONCLUSION: GA seems to more accurately reflects fasting plasma glucose level than HbA1c. GA, GA/HbA1c ratio appear to reflect insulin secretory function.
Adult ; Blood Glucose ; C-Peptide ; Child ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Glycemic Index ; Hemoglobin A, Glycosylated ; Humans ; Insulin

Diabetes mellitus (DM) can be classified as type 1, type 2, and other specific types according to the underlying causes. Other specific types include genetic defects of beta-cell function, insulin action, and other genetic syndromes associated with diabetes. Most childhood diabetes has been thought of as type 1 diabetes mellitus (T1DM), but the incidence of type 2 (T2DM) in childhood is rapidly increasing and it can be caused by monogenic defect. In some cases, it might not be easy to determine the type of diabetes and to choose the appropriate treatment. Many susceptible genes to the development of T1DM, T2DM as well as the causative genes of the monogenic diabetes have been identified due to the development of genome-wide association studies, candidate gene analysis and familial linkage studies. Study of the genetic factors in diabetes mellitus is valuable because it enables more appropriate management, and better prediction of disease progression. Therefore, it is important to consider the genetic factors in the management of childhood diabetes.
Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Disease Progression ; Genetic Association Studies ; Genome-Wide Association Study ; Incidence ; Insulin

BACKGROUND: It is well known that the clinical characteristics of diabetes mellitus in Korean people are different from those of Western people. The purpose of this study was to investigate the prevalence of the anti-GAD antibody (GADA) in a large number of Korean patients with adult-onset diabetes. METHODS: The GADA was measured by radioimmunoassay for 11,472 adult-onset diabetic patients who visited the Asan Medical Center from 1998 to 2007. According to the fasting C-peptide levels, we classified the patients into an insulin dependent diabetes mellitus group (IDDM; C-peptide < 0.6 ng/mL) and non-insulin dependent diabetes mellitus group (NIDDM; C-peptide > or = 1.0 ng/mL). Other clinical and laboratory data were obtained from medical records. RESULTS: Among the 11,147 diabetic patients, 9,250 patients were classified as NIDDM, 922 patients were classified as IDDM and 975 patients excluded. Within the latter group 472 patients were to absolute insulin deficient (C-peptide < 0.1 ng/mL). The prevalence of GADA was 22.0% in the IDDM group and 4.7% in the NIDDM group. GADA was more prevalent in younger-onset NIDDM patients (25~40 years of age; 12.4%) than in older-onset NIDDM patients (> or = 40 years of age; 3.8%). The GADA-positive NIDDM patients had lower C-peptide and BMI levels, and higher rates of typical diabetic symptoms and insulin treatment. CONCLUSION: The prevalence of GADA in Korean patients with IDDM and NIDDM was lower than that reported in Western populations. It is thus suggested that autoimmunity is a rarer cause of diabetes in Korean people. However, since over 10% of younger-onset NIDDM patients were positive for GADA, routine GADA measurement in such patients is recommended.
Autoimmunity ; C-Peptide ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Fasting ; Glutamate Decarboxylase ; Humans ; Insulin ; Korea ; Medical Records ; Prevalence ; Radioimmunoassay

Acromegaly is generally caused by a benign growth hormone (GH)-secreting pituitary adenoma. It is characterized by a wide range of complications; cardiovascular, respiratory, bone and joint, and metabolic complications. Among them, impaired glucose tolerance and diabetes mellitus, due to GH-induced insulin resistance, has been reported in approximately 16-46% and 19-56%. They are usually improved following the treatment of acromegaly, surgical or medical therapy. We report a first case of 36-year-old man who was paradoxically diagnosed with GAD antibody positive latent autoimmune diabetes in adults (LADA) after the surgical cure of acromegaly.
Acromegaly ; Adult ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Glucose ; Growth Hormone ; Humans ; Insulin Resistance ; Joints ; Pituitary Neoplasms