Different Pathophysiological Phenotypes among Newly Diagnosed Type 2 Diabetes Patients

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskning

Resumé

Type 2 diabetes (T2D) can be considered a syndrome with several different pathophysiological mechanisms leading to hyperglycemia. Nonetheless, T2D is treated according to algorithms as if it was one disease entity.
Methods: We investigated the prevalence of different pathophysiological phenotypes among newly diagnosed T2D patients in Denmark. Based on baseline data from a Danish national cohort study we investigated 1048 incident diagnosed T2D patients. The diagnosis T2D was made by general practitioners based on clinical judgement. Phenotypes were classified in the following groups: latent autoimmune diabetes (LADA) (GAD antibody titer >= 20 IE/ml and not T1D), secondary diabetes (recent history of pancreatitis, pancreatectomy or pancreas amylase > 65U/l, and GAD negativity), steroid-induced diabetes (oral glucocorticoid-treated subjects), insulinopenic (f-P-C-peptide < 333 pmol/l and not LADA or secondary diabetes), classic obesity-associated insulin resistant diabetes ( f-P-C-peptide >= 568 pmol/l) and a normoinsulinopenic group (333 <=c-peptid <=568 pmol/l).
Results: Median age of our new T2D patients was 61 years (range 21-95 years), 57% were men. We found that 3.0% newly diagnosed T2D patients suffered from LADA, 3.9% from secondary diabetes, 6.0% from steroid induced diabetes 5.9% had insulinopenic diabetes, whereas 56.7% presented the classic obesity-associated insulin-resistant phenotype. 24.6% was classified as normoinsulinopenic patients.
Conclusion: We conclude that newly diagnosed T2D patients represents several well-characterized pathophysiological phenotypes with various mechanisms of hyperglycemia. This should be taken into consideration when choosing the appropriate treatment for the individual patient diagnosed with T2D. We suggest to measure f-P-C-peptide, GAD antibodies and pancreas amylase in patients with newly diagnosed T2D.
OriginalsprogEngelsk
Publikationsdatojun. 2013
StatusUdgivet - jun. 2013

Emneord

  • diabetes
  • phenotypes

Citer dette

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title = "Different Pathophysiological Phenotypes among Newly Diagnosed Type 2 Diabetes Patients",
abstract = "Type 2 diabetes (T2D) can be considered a syndrome with several different pathophysiological mechanisms leading to hyperglycemia. Nonetheless, T2D is treated according to algorithms as if it was one disease entity. Methods: We investigated the prevalence of different pathophysiological phenotypes among newly diagnosed T2D patients in Denmark. Based on baseline data from a Danish national cohort study we investigated 1048 incident diagnosed T2D patients. The diagnosis T2D was made by general practitioners based on clinical judgement. Phenotypes were classified in the following groups: latent autoimmune diabetes (LADA) (GAD antibody titer >= 20 IE/ml and not T1D), secondary diabetes (recent history of pancreatitis, pancreatectomy or pancreas amylase > 65U/l, and GAD negativity), steroid-induced diabetes (oral glucocorticoid-treated subjects), insulinopenic (f-P-C-peptide < 333 pmol/l and not LADA or secondary diabetes), classic obesity-associated insulin resistant diabetes ( f-P-C-peptide >= 568 pmol/l) and a normoinsulinopenic group (333 <=c-peptid <=568 pmol/l). Results: Median age of our new T2D patients was 61 years (range 21-95 years), 57{\%} were men. We found that 3.0{\%} newly diagnosed T2D patients suffered from LADA, 3.9{\%} from secondary diabetes, 6.0{\%} from steroid induced diabetes 5.9{\%} had insulinopenic diabetes, whereas 56.7{\%} presented the classic obesity-associated insulin-resistant phenotype. 24.6{\%} was classified as normoinsulinopenic patients. Conclusion: We conclude that newly diagnosed T2D patients represents several well-characterized pathophysiological phenotypes with various mechanisms of hyperglycemia. This should be taken into consideration when choosing the appropriate treatment for the individual patient diagnosed with T2D. We suggest to measure f-P-C-peptide, GAD antibodies and pancreas amylase in patients with newly diagnosed T2D.",
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Different Pathophysiological Phenotypes among Newly Diagnosed Type 2 Diabetes Patients. / Stidsen, Jacob.

2013.

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskning

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PY - 2013/6

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N2 - Type 2 diabetes (T2D) can be considered a syndrome with several different pathophysiological mechanisms leading to hyperglycemia. Nonetheless, T2D is treated according to algorithms as if it was one disease entity. Methods: We investigated the prevalence of different pathophysiological phenotypes among newly diagnosed T2D patients in Denmark. Based on baseline data from a Danish national cohort study we investigated 1048 incident diagnosed T2D patients. The diagnosis T2D was made by general practitioners based on clinical judgement. Phenotypes were classified in the following groups: latent autoimmune diabetes (LADA) (GAD antibody titer >= 20 IE/ml and not T1D), secondary diabetes (recent history of pancreatitis, pancreatectomy or pancreas amylase > 65U/l, and GAD negativity), steroid-induced diabetes (oral glucocorticoid-treated subjects), insulinopenic (f-P-C-peptide < 333 pmol/l and not LADA or secondary diabetes), classic obesity-associated insulin resistant diabetes ( f-P-C-peptide >= 568 pmol/l) and a normoinsulinopenic group (333 <=c-peptid <=568 pmol/l). Results: Median age of our new T2D patients was 61 years (range 21-95 years), 57% were men. We found that 3.0% newly diagnosed T2D patients suffered from LADA, 3.9% from secondary diabetes, 6.0% from steroid induced diabetes 5.9% had insulinopenic diabetes, whereas 56.7% presented the classic obesity-associated insulin-resistant phenotype. 24.6% was classified as normoinsulinopenic patients. Conclusion: We conclude that newly diagnosed T2D patients represents several well-characterized pathophysiological phenotypes with various mechanisms of hyperglycemia. This should be taken into consideration when choosing the appropriate treatment for the individual patient diagnosed with T2D. We suggest to measure f-P-C-peptide, GAD antibodies and pancreas amylase in patients with newly diagnosed T2D.

AB - Type 2 diabetes (T2D) can be considered a syndrome with several different pathophysiological mechanisms leading to hyperglycemia. Nonetheless, T2D is treated according to algorithms as if it was one disease entity. Methods: We investigated the prevalence of different pathophysiological phenotypes among newly diagnosed T2D patients in Denmark. Based on baseline data from a Danish national cohort study we investigated 1048 incident diagnosed T2D patients. The diagnosis T2D was made by general practitioners based on clinical judgement. Phenotypes were classified in the following groups: latent autoimmune diabetes (LADA) (GAD antibody titer >= 20 IE/ml and not T1D), secondary diabetes (recent history of pancreatitis, pancreatectomy or pancreas amylase > 65U/l, and GAD negativity), steroid-induced diabetes (oral glucocorticoid-treated subjects), insulinopenic (f-P-C-peptide < 333 pmol/l and not LADA or secondary diabetes), classic obesity-associated insulin resistant diabetes ( f-P-C-peptide >= 568 pmol/l) and a normoinsulinopenic group (333 <=c-peptid <=568 pmol/l). Results: Median age of our new T2D patients was 61 years (range 21-95 years), 57% were men. We found that 3.0% newly diagnosed T2D patients suffered from LADA, 3.9% from secondary diabetes, 6.0% from steroid induced diabetes 5.9% had insulinopenic diabetes, whereas 56.7% presented the classic obesity-associated insulin-resistant phenotype. 24.6% was classified as normoinsulinopenic patients. Conclusion: We conclude that newly diagnosed T2D patients represents several well-characterized pathophysiological phenotypes with various mechanisms of hyperglycemia. This should be taken into consideration when choosing the appropriate treatment for the individual patient diagnosed with T2D. We suggest to measure f-P-C-peptide, GAD antibodies and pancreas amylase in patients with newly diagnosed T2D.

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