A diagnostic approach for defining idiopathic remitting diabetes: a retrospective cohort study

2.50
Hdl Handle:
http://hdl.handle.net/11287/593839
Title:
A diagnostic approach for defining idiopathic remitting diabetes: a retrospective cohort study
Authors:
Babiker, T.; Chakera, Ali J.; Shepherd, Maggie ( 0000-0003-2660-0955 ) ; Hattersley, Andrew T.
Abstract:
BACKGROUND: 11 patients were referred to our Molecular Genetics Department at the Royal Devon and Exeter Hospital between 2000-2012 with a physician's diagnosis of remitting diabetes. Our aim was to identify patients with remitting diabetes whose clinical presentation is not explained by any known aetiology of diabetes. METHODS: We obtained longitudinal clinical data on all 11 patients from the hospital records. All patients were aged between 0.5 and 35 years at diagnosis. We applied clinical criteria derived from the literature to establish 1) definite diabetes, 2) diabetes initially severe-requiring treatment with insulin, 3) remission of diabetes, and 4) exclusion of known causes of remitting diabetes. RESULTS: 10 out of 11 patients had an alternative explanation for their remission or a clear diagnosis was not identified. We identified a single patient with idiopathic remitting diabetes using these criteria. The patient was a white Caucasian female diagnosed aged 15 with symptoms of diabetes, laboratory glucose of 21.2 mmol/L and HbA1c 134 mmol/mol. Her BMI was 23.6 kg/m2. She was treated with basal bolus insulin but discontinued two years after diagnosis due to hypoglycaemia. 13 years post diagnosis, she had a normal oral glucose tolerance test during pregnancy (fasting glucose 4.5 mmol/L, 2 hr glucose 4.8 mmol/L) and an HbA1c of 30 mmol/mol. This patient does not appear to have Type 1 or Type 2 diabetes, and furthermore does not fit into current classifications of diabetes. CONCLUSIONS: Idiopathic remitting diabetes is rare but does exist. Strict clinical criteria are important to ensure patients have a robust clinical diagnosis. Identification of more patients with idiopathic remitting diabetes will enable further study of the clinical course of this syndrome. Applying these strict criteria will allow the identification of patients with remitting diabetes to assess its aetiology.
Citation:
BMC Endocr Disord. 2014 Jun 9;14:45.
Publisher:
BioMed Central
Journal:
BMC endocrine disorders
Issue Date:
1-Jun-2014
URI:
http://hdl.handle.net/11287/593839
DOI:
10.1186/1472-6823-14-45
PubMed ID:
24909320
Additional Links:
http://bmcendocrdisord.biomedcentral.com/articles/10.1186/1472-6823-14-45
Note:
This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
Type:
Case Report; Research Support, Non-U.S. Gov't
Language:
eng
ISSN:
1472-6823
Appears in Collections:
2014 RD&E publications; Diabetes/Endocrine Services

Full metadata record

DC FieldValue Language
dc.contributor.authorBabiker, T.en
dc.contributor.authorChakera, Ali J.en
dc.contributor.authorShepherd, Maggieen
dc.contributor.authorHattersley, Andrew T.en
dc.date.accessioned2016-01-19T12:35:36Zen
dc.date.available2016-01-19T12:35:36Zen
dc.date.issued2014-06-01en
dc.identifier.citationBMC Endocr Disord. 2014 Jun 9;14:45.en
dc.identifier.issn1472-6823en
dc.identifier.pmid24909320en
dc.identifier.doi10.1186/1472-6823-14-45en
dc.identifier.urihttp://hdl.handle.net/11287/593839en
dc.description.abstractBACKGROUND: 11 patients were referred to our Molecular Genetics Department at the Royal Devon and Exeter Hospital between 2000-2012 with a physician's diagnosis of remitting diabetes. Our aim was to identify patients with remitting diabetes whose clinical presentation is not explained by any known aetiology of diabetes. METHODS: We obtained longitudinal clinical data on all 11 patients from the hospital records. All patients were aged between 0.5 and 35 years at diagnosis. We applied clinical criteria derived from the literature to establish 1) definite diabetes, 2) diabetes initially severe-requiring treatment with insulin, 3) remission of diabetes, and 4) exclusion of known causes of remitting diabetes. RESULTS: 10 out of 11 patients had an alternative explanation for their remission or a clear diagnosis was not identified. We identified a single patient with idiopathic remitting diabetes using these criteria. The patient was a white Caucasian female diagnosed aged 15 with symptoms of diabetes, laboratory glucose of 21.2 mmol/L and HbA1c 134 mmol/mol. Her BMI was 23.6 kg/m2. She was treated with basal bolus insulin but discontinued two years after diagnosis due to hypoglycaemia. 13 years post diagnosis, she had a normal oral glucose tolerance test during pregnancy (fasting glucose 4.5 mmol/L, 2 hr glucose 4.8 mmol/L) and an HbA1c of 30 mmol/mol. This patient does not appear to have Type 1 or Type 2 diabetes, and furthermore does not fit into current classifications of diabetes. CONCLUSIONS: Idiopathic remitting diabetes is rare but does exist. Strict clinical criteria are important to ensure patients have a robust clinical diagnosis. Identification of more patients with idiopathic remitting diabetes will enable further study of the clinical course of this syndrome. Applying these strict criteria will allow the identification of patients with remitting diabetes to assess its aetiology.en
dc.language.isoengen
dc.publisherBioMed Centralen
dc.relation.urlhttp://bmcendocrdisord.biomedcentral.com/articles/10.1186/1472-6823-14-45en
dc.titleA diagnostic approach for defining idiopathic remitting diabetes: a retrospective cohort studyen
dc.typeCase Reporten
dc.typeResearch Support, Non-U.S. Gov'ten
dc.identifier.journalBMC endocrine disordersen
dc.description.noteThis article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.en

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