Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Autoimmune thyropathies are frequent in patients with type 1 diabetes mellitus. Some recently published papers confirm similarly high prevalence of autoimmune thyropathies also in patients with type 2 diabetes mellitus. Chronic autoimmune thyroiditis is the most frequent form of autoimmune thyropathies. Authors examined 79 accidentally selected diabetics (38 women and 41 men, x = 55.4 +/- 2.8). Diabetic patients were divided into three groups. 20 patients with type 1 diabetes mellitus - classical form were the first group, 12 patients with LADA were the second group and 47 patients with type 2 diabetes mellitus constituted the third group. Authors diagnosed chronic autoimmune thyroiditis in 8 (40 %) patients in the group of patients with type 1 diabetes mellitus, in 6 (50%) in the group of patients with LADA and in 20 (43%) of patients with type 2 diabetes mellitus. They didn't find out statistically more frequent prevalence of chronic autoimmune thyroiditis in all groups of patients with diabetes (patients with type 1 diabetes mellitus, patients with LADA, patients with type 2 diabetes mellitus) in comparison with control group of non-diabetic subjects. They found out statistically significant more frequent prevalence of chronic autoimmune thyroiditis in diabetics of woman gender and in diabetics with positive family history of thyropathies. Results of paper confirm recommendation of examining once or twice a year autoantibodies against thyroid gland and level of thyrotropin (TSH) with the aim of early finding of laboratory manifestation of thyroidal autoimmunity or developing functional disorder.
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PMID:[Autoimmune thyropathies in diabetics]. 1662 76

Differentiation of the various forms of diabetes is necessary for therapeutic reasons. Typical signs of type 2 diabetes are age over 40, obesity, and other markers for metabolic syndrome, a positive famitory, gradual development of the classical symptoms, and no evidence of ketosis. It is important to distinguish this from LADA (latent autoimmune diabetes of adulthood), a form of type 1 diabetes mellitus. To establish this differential diagnosis antibody testing is employed. Antibody tests in patients with newly manifest diabetes make good sense when the clinical diagnosis is not unequivocal, that is, to distinguish it from type 2 diabetes, MODY diabetes, hereditary and secondary forms. At present, immunodiagnosis is used too often in unambiguous cases of type 1 diabetes, but too rarely in supposed type 2 diabetes. As a rule, LADA patients are GADA-positive. If MODY diabetes is suspected, a genetic examination is indicated. In patients with GDM, antibody testing with GADA makes sense, in particular in slim patients receiving insulin treatment, since these patients have a high risk for developing a postpartum diabetes already in the first years.
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PMID:[Diabetes mellitus--differential diagnosis]. 1680 91

We explored the importance of the genetic markers microsatellite TNFa, HLA-DR3-DQ2, and DR4-DQ8 in diabetes mellitus. The studied groups comprised autoimmune type 1 (n = 63), nonautoimmune type 1 (n = 35), latent autoimmune diabetes in adults (LADA; n = 54), and nonautoimmune type 2 (n = 340) and these patients were compared to 117 healthy controls. HLA genotyping was done with polymerase chain reaction and sequence-specific oligonucleotides. TNFa microsatellites were determined with polymerase chain reaction and fragment size determination. Univariate analysis of these genetic risk factors demonstrated that homozygosity for TNFa2/2 was a significant risk factor for autoimmune type 1 diabetes (odds ratio (OR) = 5.82; 95% confidence interval (95%CI) 1.97-17.2), for autoimmune negative type 1 diabetes (OR = 4.63; 95%CI 1.32-16.2), and for LADA (OR = 3.90; 95%CI 1.21-12.5). Moreover, heterozygosity for HLA-DR3-DQ2/DR4-DQ8 was an important risk factor for autoimmune type 1 diabetes (OR = 16.4; 95%CI 3.60-75) as was DR4-DQ8/x (OR = 2.52; 95%CI 1.27-4.98). Heterozygosity for HLA-DR3-DQ2/DR4-DQ8 was a risk factor also for LADA (OR = 10.0; 95%CI 2.05-48.9). Neither HLA-DR3-DQ2 nor DR4-DQ8 were risk factors for nonautoimmune type 1 or type 2 diabetes. We concluded that heterozygosity for DR3-DQ2/DR4-DQ8 and to some extent homozygosity for TNFa2/2 were risk factors for autoimmune diabetes irrespective of the clinical classification.
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PMID:Polymorphisms of TNF microsatellite marker a and HLA-DR-DQ in diabetes mellitus-a study in 609 Swedish subjects. 1682 7

Common polymorphisms in the transcription factor 7-like 2 gene (TCF7L2) have been associated with type 2 diabetes in different populations and recently with LADA, but not with type 1 diabetes. The aim of our study was to investigate association between the rs7903146 polymorphism in the TCF7L2 gene and LADA in Polish patients. Link between the "high risk for type 2 diabetes genotype" with clinical features was analyzed. 68 newly diagnosed patients with LADA and 195 healthy controls were genotyped for the rs7903146 polymorphism in the TCF7L2 gene using the PCR-based RFLP method. Fasting C peptide level was measured by ELISA. We observed increased frequencies of the TT genotype of the rs7903146 polymorphism in the TCF7L2 gene in LADA patients compared to controls (15 vs. 6%, P = 0.03). Fasting C peptide serum concentration was significantly lower in group of patients with LADA carrying the TT genotype (P < 0.01). In conclusion, the data from this study confirmed previous results showing genetic similarities between patients with LADA and type 2 diabetes. Non-autoimmune mechanism may be related to beta cell dysfunction in patients with LADA.
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PMID:Transcription factor 7-like 2-gene polymorphism is related to fasting C peptide in latent autoimmune diabetes in adults (LADA). 1953 15

Practitioners can be faced with cases of diabetes that do not clearly correspond to the clinical characteristics of type 1 or type 2 diabetes. They should take into account forms of diabetes such as MODY or LADA, which often go unrecognised in spite of significant prevalence. Various tests can be conducted to measure insulin secretion and resistance, and to check whether the disease is auto-immune. This makes for correct diagnosis and prescription of the appropriate course of treatment.
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PMID:[Type 1 or 2 diabetes? Or other?]. 1957 19

Extract: Epidemiologists have estimated that, by the year 2025, 250-300 million individuals worldwide will have diabetes mellitus, which consists of variable degrees of insulin-producing beta-cell dysfunction that is responsible for hyperglycemia (high level of sugar in the blood). The predominant form is type 2 diabetes (T2D), also called noninsulin-dependent diabetes mellitus (NIDDM), which is associated with insulin resistance (cells stop responding to insulin) and mainly affects obesity-prone mature adults. By contrast, type 1 diabetes (T1D) or insulin-dependent diabetes mellitus (IDDM), the less common form (characterized by a lack of insulin), also described as autoimmune diabetes, is predominantly observed in children and young adults. However, for several years, the clinical features of diabetes have been changing, as demonstrated by the late appearance of autoimmune signs that are characteristic of T1D, in adults initially diagnosed as having T2D (called latent autoimmune diabetes of adults or LADA), and of T2D in children or young adults. Intriguingly, accumulating evidence indicates that T2D and related obesity are linked to inflammation.
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PMID:Immune cells: Actors in pancreas development and regeneration that fail to fulfill their role and lead to diabetes? 2070 72

Highly sensitive and specific radioimmunoassays have been validated for autoantibodies reacting with the four major autoantigens identified so far in autoimmune diabetes. However, the analysis of this large number of autoantigens has increased the costs and time necessary for complete autoantibody screenings. Our aim was to demonstrate that it is possible to detect the immunoreactivity against a combination of four different autoantigens by a single assay, this representing a rapid, low-cost first approach to evaluate humoral autoimmunity in diabetes. By using this novel multi-autoantigen radioimmunoassay (MAA), in subsequent steps we analysed 830 sera, 476 of known and 354 of unknown diabetes-specific immunoreactivity, collected from various groups of individuals including type 1 and type 2 diabetes patients, autoantibody-positive patients with a clinical diagnosis of type 2 diabetes (LADA), prediabetic subjects, individuals at risk to develop autoimmune diabetes, siblings of type 1 diabetic patients, coeliac patients and healthy control subjects. All sera reacting with one or more of the four autoantigens by single assays also resulted positive with MAA, as well as eight of 24 type 1 diabetic patients classified initially as autoantibody-negative at disease onset based on single autoantibody assays. In addition, MAA showed 92% sensitivity and 99% specificity by analysing 140 blinded sera from type 1 diabetic patients and control subjects provided in the 2010 Diabetes Autoantibody Standardization Program. MAA is the first combined method also able to evaluate, in addition to glutamic acid decarboxylase (GAD) and tyrosine phosphatase (IA)-2, insulin and islet beta-cell zinc cation efflux transporter (ZnT8) autoantibodies. It appears to be particularly appropriate as a first-line approach for large-scale population-based screenings of anti-islet autoimmunity.
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PMID:Detection of four diabetes specific autoantibodies in a single radioimmunoassay: an innovative high-throughput approach for autoimmune diabetes screening. 2205 88

Gestational diabetes screening using a 75 g oral glucose tolerance test should be offered to all pregnant women, except those who are at low risk. 10-15% of gestational diabetes is caused by LADA (Latent Autoimmune Diabetes in Adults) or MODY (Maturity Onset Diabetes in the Young), in which mothers generally sustain a normal body weight. The diagnostic criteria for gestational diabetes are venous plasma glucose levels > or = 5.3 mmol/l (fasting), > or = 10.0 mmol/I (1 h) and > or = 8.6 mmol/l (2 h). Achieving a normal body weight is crucially important to mothers after delivery.
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PMID:[Update on current care guideline: gestational diabetes]. 2415 12

Incidence of diabetes is increasing worldwide at an alarming rate. Therefore, a proper understanding of the mechanisms and efficient treatment of the disease is becoming increasingly important. The article briefly describes controversies in type 1 diabetes (T1DM) pathogenesis and diagnosis (genetic background, accelerator hypothesis, new autoantibodies, new information on LADA - latent autoimmune diabetes in adults, and the role of TRAIL - tumor necrosis factor-related apoptosis-inducing ligand) and treatment (how to deal with fluctuations of blood glucose concentrations and the occurrence of hypoglycemia, the role of healthy lifestyle, especially physical exercise, and a proper diet, treatment of insulin resistance and the challenges in detecting diabetic neuropathy). Moreover, issues in the pathogenesis of macrovascular complications in type 2 diabetes (T2DM) are considered (novel risk factors - vascular hyperglycemic memory, hypoglycemia, altered profile of microRNAs expression, impaired function of vascular progenitor cells, altered fibrin clot properties and iron-induced blood coagulation). Modern treatment of T2DM, based on lifestyle intervention and antidiabetic drugs, is full of controversies and it seems that over time the number of uncertainties is constantly increasing. Recent trials have reported disappointing results in lifestyle intervention (LOOK-AHEAD) and antihyperglycemic treatment (ACCORD, SAVOR-TIMI 53, EXAMINE, concerns about sulfonylureas safety). Moreover, there are considerable deviations from treatment targets that are recommended by the guidelines (blood glucose, hypertension, blood lipids) in real-life clinical practice in patients at different stages of the disease development. It seems that beneficial modification of the natural history of diabetes is unlikely in the foreseeable future unless we are able to obtain a more in-depth understanding of the pathomechanisms of the disease.
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PMID:Controversies in diabetes in 2013 - a brief update. 2443 5

Genome-wide association studies (GWAS) published in the last decade raised the number of loci associated with type 1 (T1D) and type 2 diabetes (T2D) to more than 50 for each of these diabetes phenotypes. The environmental factors seem to play an important role in the expression of these genes, acting through transcription factors that bind to promoters. Using the available databases we examined the promoters of various genes classically associated with the two main diabetes phenotypes. Our comparative analyses have revealed significant architectural differences between promoters of genes classically associated with T1D and T2D. Nevertheless, five gene promoters (about 16%) belonging to T1D and six gene promoters (over 19%) belonging to T2D have shown some intermediary structural properties, suggesting a direct relationship to either LADA (Latent Autoimmune Diabetes in Adults) phenotype or to non-autoimmune type 1 phenotype. The distribution of these promoters in at least three separate classes seems to indicate specific pathogenic pathways. The image-based patterns (DNA patterns) generated by promoters of genes associated with these three phenotypes support the clinical observation of a smooth link between specific cases of typical T1D and T2D. In addition, a global distribution of these DNA patterns suggests that promoters of genes associated with T1D appear to be evolutionary more conserved than those associated with T2D. Though, the image based patterns obtained by our method might be a new useful parameter for understanding the pathogenetic mechanism and the diabetogenic gene networks.
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PMID:Structural Properties of Gene Promoters Highlight More than Two Phenotypes of Diabetes. 2637 45


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