Diagnostic Dilemma: Clinical and Histological Abnormalities in a Hispanic Patient With Diabetes  

Oleh:

Jacobsen, Laura M. ; Posgai, Amanda L. ; Campbell-Thompson, Martha ; Schatz, Desmond A.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 39 no. 09 (Sep. 2016), page 1650-1652.
Topik: Type 1 Diabetes; T1D

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

The review of organ donors’ medical history is often limited to the terminal hospitalization records. This 32-year-old Hispanic patient had a history of type 1 diabetes since age 13 years and was treated with insulin since diagnosis. However, we have reasons to challenge the clinical diagnosis. The HLA region provides the highest contribution to genetic risk for type 1 diabetes (2). Although the HLA profile observed for this patient is not known to be associated with either risk or protection (2,3), there has been a recent rise in type 1 diabetes incidence among patients with HLA considered to confer lower risk for developing the disease (4). The absence of type 1 diabetes–associated autoantibodies (i.e., glutamic acid decarboxylase, insulinoma-associated protein 2, zinc transporter 8) at the time of study may be attributable to autoantibody loss over time; the absence altogether has been reported in type 1 diabetes in a mere 10% of cases at diagnosis (5). Although only 5%–10% of all diabetes is type 1, the vast majority of patients are diagnosed when they are children and young adults. Although there is increasing awareness of latent autoimmune diabetes in adults, it is most often diagnosed as type 2 diabetes (6).

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