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World Diabetes Day
      Date:2019-11-14
It’s estimated that 629 million people will be affected by diabetes by 2045. Diabetes is a group of conditions characterized by increased thirst, frequent urination, extreme hunger, unexplained weight loss, etc. It’s closely linked with insulin deficiency and insulin resistance, causing hyperglycemia, and seriously, leading to a number of acute and chronic health problems, like diabetic nephropathy, cardiovascular disease, etc.

Diabetes Types
Type 1 diabetes: thought to be an autoimmune disease because of the destruction of beta cells in the pancreas; can occur at any age but usually diagnosed in children and young adults.
Conditions associated with T1DM: coeliac disease, rheumatoid arthritis, autoimmune thyroid disease

Type 2 diabetes: most common type; associated with insulin resistance. It develops most frequently in overweight middle-aged and elderly people. 
Conditions closely linked with T2DM: Alzheimer’s disease, PCOS, Cushing syndrome, pancreatic cancer

Gestational diabetes: hormones produced by the placenta cause insulin resistance, typically developed late in the pregnancy (24-28 weeks) and affecting both mother and baby
Specific types due to other causes: including monogenic diabetes and drug - or chemical - induced diabetes.

Total solution for diabetes
Predictive marker: adiponectin, to predict the risk of type 2 diabetes at least 10 years in advance.
Differential diagnosis: IA-2A, IAA, GADA, ICA, ZnT8A, to predict autoimmune diabetes and distinguish between type 1 and type 2 diabetes. 
Supportive markers to realize differentiation: RA (RF, CCP), autoimmune thyroid disease (Anti-Tg, Anti-TPO, Anti-TSHR), coeliac disease (tTG, DGP), Cushing syndrome (cortisol), pancreatic cancer (CA 19-9)
Monitoring: Insulin, C-Peptide, to identify endogenous insulin levels and monitor insulin treatment. 

Diabetes Care
For T1DM, insulin treatment is necessary, most patients will take insulin by injection with insulin pens. Besides, understanding how to balance insulin dose with dietary intake and physical activity is also important.
For T2DM, a combination of diet modification with regular and appropriate exercise, high-fibre, low-carb and low calorie diet is encouraged by NICE guidelines; Metformin is one of the most common drugs for patients with T2DM, insulin injection may also be needed for those who have had T2DM for a number of years.


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