Classification of diabetes in young adults: new concepts for an old disease.
As clinicians, we are faced to difficult situations in young diabetic patients. The prevalence of type 2 diabetes increases in these patients due to a rising incidence of obesity. We present two clinical observations which both illustrate the insufficiencies of the present classifications. Modern tools are now available for diagnosis such as anti-GAD65 and IA-2 antibodies, genetic tools to investigate for specific mutations, but quantitative means of beta cell mass are lacking. Clinical examination is still accurate to identify type 1 or type 2 diabetes, MODY and mitochondrial diabetes. Weight curve, lesions of acanthosis nigricans, criteria of metabolic syndrome, history of diabetes are critical factors. This problematic has important consequences in our daily practice: the right choice for rapid and good metabolic control.
Cugnet
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Department of Endocrinology, Hôpital Edouard Herriot, Place d'Arsonval, 69003 Lyon, France.
Thivolet
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D000328:Adult; D000367:Age Factors; D048909:Diabetes Complications / Q000175:diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000145:classification* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000145:classification* / Q000517:prevention & control; D005260:Female; D006801:Humans; D009765:Obesity / Q000175:diagnosis