Symposium 16: Clinical presentation. Diagnostic difficulties
DOI:
https://doi.org/10.47196/diab.v56i3Sup.592Keywords:
autoimmune diabetesAbstract
Autoimmune diabetes is the type of DM characterized by autoimmune destruction of the beta cell by the cellular immune system in genetically predisposed people (mainly HLA polymorphisms) and with an environmental trigger that is generally not well known.
From a clinical point of view, it has traditionally been considered a type of DM that begins in childhood and adolescence, with a high genetic predisposition, aggressive destruction of the beta cell mass, rapid fall in insulin secretion, and presentation in ketosis or ketoacidosis. However, immune-mediated DM in adults is currently the most frequent form of presentation of autoimmune DM (even more than in the childhood and youth stage). In this case, it does not behave as such a homogeneous group of presentation since, although some (the smallest percentage) may debut in ketoacidosis, the vast majority present with progressive hyperglycemia that in many circumstances can simulate forms of presentation of T2DM. This is because in these cases, not only is genetic predisposition linked to HLA polymorphisms, but also to other polymorphisms that determine beta cell secretion failure and even overweight/obesity can play a determining role in the pathophysiology of the disease. Immune-mediated DM in adults.
References
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II. Holt RH, DeVries JH, Hess-Fischl A, et al. The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2021;44(11):2589-2625. doi: 10.2337/dci21-0043.
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