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不同病因所致继发性糖尿病:4例病例报告

Secondary diabetes due to different etiologies: Four case reports.

作者信息

Song Wen-Rong, Xu Xiao-Hong, Li Jia, Yu Jia, Li Yan-Xiong

机构信息

Department of Endocrinology, Hanchuan People's Hospital, Xiaogan 431600, Hubei Province, China.

Department of Pneumology, Hanchuan People's Hospital, Xiaogan 431600, Hubei Province, China.

出版信息

World J Clin Cases. 2024 Jun 6;12(16):2813-2821. doi: 10.12998/wjcc.v12.i16.2813.

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.

CASE SUMMARY

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.

CONCLUSION

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推进,该疾病出现了更复杂的分类,揭示了特殊类型糖尿病的存在,其中许多患者容易被误诊和漏诊,导致治疗延误和医疗费用增加。本研究的目的是确定继发性糖尿病的四个病因。

病例摘要

继发性糖尿病可由多种因素引起,其中一些因素常被忽视。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。本文描述了由威廉姆斯-贝伦综合征、普拉德-威利综合征、垂体腺瘤和IgG4相关疾病引起的四种继发性糖尿病类型。由于这些病例发病率低且罕见,其疾病进展与典型情况有显著差异,在临床实践中常被忽视。与普通糖尿病患者相比,这里描述的四名患者表现出明显的特征。标准的降糖治疗未能有效控制病情。随后,一系列检查和随访病史证实了糖尿病的诊断及其潜在病因。在解决原发性疾病,如切除垂体腺瘤、补充糖皮质激素并进行对症治疗后,所有患者的血糖水平均大幅下降,随后维持在稳定范围内。此外,其他伴随症状也有所改善。

结论

在糖尿病诊断中,常未考虑到导致继发性糖尿病的罕见疾病。因此,必要时进行基因检测、抗体检测等适当的诊断措施至关重要,以便通过积极有效地管理潜在疾病促进早期诊断和干预,最终改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8790/11185335/7cfa8d728084/WJCC-12-2813-g001.jpg

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