Secondary Diabetes Mellitus – Hyperglycemia

by Carlo Raj, MD

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    Secondary, what does this mean to you? You’re developing hyperglycemia due to other endocrinopathies. What does Cushing’s mean to you? Too much cortisol. What is that going to do? It’s going to increase gluconeogenesis and it will then impair peripheral utilization resulting in hyperglycemia. What’s the hormone in acromegaly? A growth hormone. What does that do? It brings about anti-insulin like effect, decreased peripheral utilization. What if you had a patient that has MEN type I and has prolactinoma, has hypercalcemia and also has… have the skin issues maybe down in the legs and such known as necrolytic migratory erythema, a glucagonoma. All of these are hyperglycemic secondary type, there was an underlying issue that resulted in secondary diabetes mellitus. Down syndrome is a big one, genetically that you want to keep in mind… trisomy 21. Hemochromatosis… now, completely all the different organs that are commonly affected in hemochromatosis - pancreas obviously; number two skin, bronzing; number three liver, fibrosis… gone. Patient may die of heart disease… hemochromatosis. Topic here, however, secondary diabetes mellitus being caused by hemochromatosis. Chronic pancreatitis, pancreatic carcinoma… Earlier we had a discussion of pancreatic islet cell tumours. Is that what this is? No. So, when you do pancreas, forever more you divide it into endocrine and exocrine… endocrine, exocrine. You divide it so that you can understand the physiologic aspects of endocrine-exocrine. You divide this so that you understand the pathologic effects. Now, granted we’re doing endocrine pathology, but if your patient, for example, you know of Steve Jobs. He died of pancreatic cancer. He died however of pancreatic adenocarcinoma. When we did our islet cell tumours of the pancreas, what were they again? Insulinoma, glucagonoma, VIPoma, somatostatinoma… completely different discussion. This is pancreatic adenocarcinoma, this is the one that you know and which we...

    About the Lecture

    The lecture Secondary Diabetes Mellitus – Hyperglycemia by Carlo Raj, MD is from the course Pancreatic Disease & Diabetes.

    Included Quiz Questions

    1. Addison's Disease
    2. Acromegaly
    3. Glucagonoma
    4. Cushing's Syndrome
    5. Down Syndrome
    1. Hemachromatosis
    2. Cushing's Syndrome
    3. Chronic pancreatitis
    4. Acromegaly
    5. Down Syndrome
    1. Decrease risk of birth complications
    2. Increase predisposition to Type II DM
    3. Increased birth weight of baby
    4. Association with hyaline membrane disease
    5. Increased insulin of child being born hypoglycemia
    1. Fetal insulin is important for anabolic growth
    2. Human placental lactogen increases maternal use of glucose
    3. Glucose cannot cross the placenta
    4. Macrosomia is present in almost all fetuses
    5. Gestational diabetes leads to rebound hyperglycemia in newborn babies

    Author of lecture Secondary Diabetes Mellitus – Hyperglycemia

     Carlo Raj, MD

    Carlo Raj, MD

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