PDF(Pubmed)
Abstract：
BACKGROUND: As research on diabetes continues to advance, more complex classifications of this disease have emerged, revealing the existence of special types of diabetes, and many of these patients are prone to misdiagnosis and underdiagnosis, leading to treatment delays and increased health care costs. The purpose of this study was to identify four causes of secondary diabetes.
METHODS: Secondary diabetes can be caused by various factors, some of which are often overlooked. These factors include genetic defects, autoimmune disorders, and diabetes induced by tumours. This paper describes four types of secondary diabetes caused by Williams-Beuren syndrome, Prader-Willi syndrome, pituitary adenoma, and IgG4-related diseases. These cases deviate significantly from the typical progression of the disease due to their low incidence and rarity, often leading to their neglect in clinical practice. In comparison to regular diabetes patients, the four individuals described here exhibited distinct characteristics. Standard hypoglycaemic treatments failed to effectively control the disease. Subsequently, a series of examinations and follow-up history confirmed the diagnosis and underlying cause of diabetes. Upon addressing the primary condition, such as excising a pituitary adenoma, providing glucocorticoid supplementation, and implementing symptomatic treatments, all patients experienced a considerable decrease in blood glucose levels, which were subsequently maintained within a stable range. Furthermore, other accompanying symptoms improved.
CONCLUSIONS: Rare diseases causing secondary diabetes are often not considered in the diagnosis of diabetes. Therefore, it is crucial to conduct genetic tests, antibody detection and other appropriate diagnostic measures when necessary to facilitate early diagnosis and intervention through proactive and efficient management of the underlying condition, ultimately improving patient outcomes.
METHODS: Secondary diabetes can be caused by various factors, some of which are often overlooked. These factors include genetic defects, autoimmune disorders, and diabetes induced by tumours. This paper describes four types of secondary diabetes caused by Williams-Beuren syndrome, Prader-Willi syndrome, pituitary adenoma, and IgG4-related diseases. These cases deviate significantly from the typical progression of the disease due to their low incidence and rarity, often leading to their neglect in clinical practice. In comparison to regular diabetes patients, the four individuals described here exhibited distinct characteristics. Standard hypoglycaemic treatments failed to effectively control the disease. Subsequently, a series of examinations and follow-up history confirmed the diagnosis and underlying cause of diabetes. Upon addressing the primary condition, such as excising a pituitary adenoma, providing glucocorticoid supplementation, and implementing symptomatic treatments, all patients experienced a considerable decrease in blood glucose levels, which were subsequently maintained within a stable range. Furthermore, other accompanying symptoms improved.
CONCLUSIONS: Rare diseases causing secondary diabetes are often not considered in the diagnosis of diabetes. Therefore, it is crucial to conduct genetic tests, antibody detection and other appropriate diagnostic measures when necessary to facilitate early diagnosis and intervention through proactive and efficient management of the underlying condition, ultimately improving patient outcomes.
摘要：
背景：随着糖尿病研究的不断深入，这种疾病的更复杂的分类已经出现，揭示了特殊类型糖尿病的存在，其中许多患者容易误诊和诊断不足，导致治疗延误和医疗费用增加。这项研究的目的是确定继发性糖尿病的四个原因。
方法：继发性糖尿病可由多种因素引起，其中一些经常被忽视。这些因素包括遗传缺陷，自身免疫性疾病，和肿瘤诱发的糖尿病。本文介绍了由Williams-Beuren综合征引起的四种类型的继发性糖尿病，Prader-Willi综合征,垂体腺瘤,与IgG4相关的疾病。这些病例由于其发病率低、稀有性而显著偏离典型的疾病进展,往往导致他们在临床实践中的忽视。与普通糖尿病患者相比，这里描述的四个人表现出鲜明的特征。标准的低血糖治疗未能有效控制疾病。随后，一系列检查和随访病史证实了糖尿病的诊断和根本原因.解决主要条件后，比如切除垂体腺瘤，提供糖皮质激素补充，实施对症治疗，所有患者的血糖水平都大幅下降，随后保持在稳定范围内。此外，其他伴随症状改善。
结论：在糖尿病的诊断中通常不考虑引起继发性糖尿病的罕见疾病。因此,进行基因测试至关重要，抗体检测和其他必要的适当诊断措施，以通过积极有效地管理潜在疾病来促进早期诊断和干预，最终改善患者预后。
方法：继发性糖尿病可由多种因素引起，其中一些经常被忽视。这些因素包括遗传缺陷，自身免疫性疾病，和肿瘤诱发的糖尿病。本文介绍了由Williams-Beuren综合征引起的四种类型的继发性糖尿病，Prader-Willi综合征,垂体腺瘤,与IgG4相关的疾病。这些病例由于其发病率低、稀有性而显著偏离典型的疾病进展,往往导致他们在临床实践中的忽视。与普通糖尿病患者相比，这里描述的四个人表现出鲜明的特征。标准的低血糖治疗未能有效控制疾病。随后，一系列检查和随访病史证实了糖尿病的诊断和根本原因.解决主要条件后，比如切除垂体腺瘤，提供糖皮质激素补充，实施对症治疗，所有患者的血糖水平都大幅下降，随后保持在稳定范围内。此外，其他伴随症状改善。
结论：在糖尿病的诊断中通常不考虑引起继发性糖尿病的罕见疾病。因此,进行基因测试至关重要，抗体检测和其他必要的适当诊断措施，以通过积极有效地管理潜在疾病来促进早期诊断和干预，最终改善患者预后。
