SlideShare uma empresa Scribd logo
1 de 10
Case 5 History:  42 yrs male presented with c/o being exhausted for past 8 month, with increased  frequency of urine at night. On further inquiring he had intense thirst but no change in appetite. Past History: No major illness in past. Family History: No evidence of family history of Diabetes
Personal History: Works as accountant, married with two children, non smoker, does not take alcohol, or any other medicines. O/E: Weight : 88 kg Height: 171 cm BMI : 30.1 kg/m2 Pulse: 80/min Regular BP : 136/84 mm of Hg Obesity CVS/RS/AS/CNS : Normal Peri Pulse: Normal felt Feet / Nails / Sensation : clinically Normal
Laboratory Ix: 1. OGTT : with 75 gm glucose FBG : 170 mg/dL,  PPBG : 310 mg/dL 2 Urine R/M: Sugar ++, Acetone: +, No proteins 3. Fundoscopy : normal 4. Hba1c: 8.9 %
Q: 1. Based on Above History what is Provisional Diagnosis? 1. Type 1 DM 2. Type 2 DM 3. LADA 4. MODY
Why LADA :  1. FBG, PP2BG and Hba1c : confirms Diabetes 2. Presence of Ketone's, in urine, favors Type 1 DM 3. No family history also favors Type1 DM 4. But his age favors Type 2 DM So to confirm what is required?
Q : 2 To confirm what else is required? 1. GAD 65  2. C peptide  3. Both 1 and 2 4. None of the above.
Analysis: His C peptide was less than normal GAD 65 was positive..... Thus confirming Type 1 DM,  But his Age and onset (not acute) are against... So diagnosis is .....LADA  (Latent Autoimmune Diabetes in Adult)
What is normal value of C peptide level? 2 to 4.5 1.2 to 3.4 0.4 to 2.1 Adult 2 to 4.5 1.2 to 3.4 0.4 to 2.2 Child ( < 15 yr) PP 2 Hr level  After Glucose load PP 2 Hr level After Meal Fasting level “ C” peptide level : Unit :nano gm/ml
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

Mais conteúdo relacionado

Mais procurados

Non alcoholic fatty liver disease
Non alcoholic fatty liver diseaseNon alcoholic fatty liver disease
Non alcoholic fatty liver diseaseakifab93
 
Endocrine hypertension
Endocrine hypertensionEndocrine hypertension
Endocrine hypertensionNaveen Kumar
 
Type 2 dm etiology & reversibility (diabetes care, april 2013)
Type 2 dm etiology & reversibility (diabetes care, april 2013)Type 2 dm etiology & reversibility (diabetes care, april 2013)
Type 2 dm etiology & reversibility (diabetes care, april 2013)Endocrinology Department, BSMMU
 
Metabolic Associated Fatty Liver Disease (MAFLD) for General Practitioners of...
Metabolic Associated Fatty Liver Disease (MAFLD) for General Practitioners of...Metabolic Associated Fatty Liver Disease (MAFLD) for General Practitioners of...
Metabolic Associated Fatty Liver Disease (MAFLD) for General Practitioners of...Dr.Tanvir Ahmad
 
Diabetes Cases.1 Ppt
Diabetes Cases.1 PptDiabetes Cases.1 Ppt
Diabetes Cases.1 PptMiami Dade
 
approach to short stature
approach to short statureapproach to short stature
approach to short statureRatnakar Vallem
 
Diabetes Remission and Prevention
Diabetes Remission and PreventionDiabetes Remission and Prevention
Diabetes Remission and PreventionUsama Ragab
 
Nafld management -_challenges_involved
Nafld management -_challenges_involvedNafld management -_challenges_involved
Nafld management -_challenges_involvedSantosh Narayankar
 
Sick day managment in diabetic children and adolescent
Sick day managment in diabetic children and adolescentSick day managment in diabetic children and adolescent
Sick day managment in diabetic children and adolescentImtiaz Baig
 
Management of dyslipidemia
Management of dyslipidemiaManagement of dyslipidemia
Management of dyslipidemiaAmir Mahmoud
 
Case studies in the managment of type 2 diabetes
Case studies in the managment of type 2 diabetes Case studies in the managment of type 2 diabetes
Case studies in the managment of type 2 diabetes NasserAljuhani
 
[2015] the treatment of diabetes mellitus of patients with chronic liver disease
[2015] the treatment of diabetes mellitus of patients with chronic liver disease[2015] the treatment of diabetes mellitus of patients with chronic liver disease
[2015] the treatment of diabetes mellitus of patients with chronic liver diseaseAyman Alsebaey
 
Diabetic Ketoacidosis Case presentation
Diabetic Ketoacidosis Case presentation Diabetic Ketoacidosis Case presentation
Diabetic Ketoacidosis Case presentation Walaa Fahad
 
Management of dm in ckd
Management of dm in ckdManagement of dm in ckd
Management of dm in ckdPraveen Nagula
 

Mais procurados (20)

Diabetic problem
Diabetic problemDiabetic problem
Diabetic problem
 
Non alcoholic fatty liver disease
Non alcoholic fatty liver diseaseNon alcoholic fatty liver disease
Non alcoholic fatty liver disease
 
Endocrine hypertension
Endocrine hypertensionEndocrine hypertension
Endocrine hypertension
 
Type 2 dm etiology & reversibility (diabetes care, april 2013)
Type 2 dm etiology & reversibility (diabetes care, april 2013)Type 2 dm etiology & reversibility (diabetes care, april 2013)
Type 2 dm etiology & reversibility (diabetes care, april 2013)
 
Metabolic Associated Fatty Liver Disease (MAFLD) for General Practitioners of...
Metabolic Associated Fatty Liver Disease (MAFLD) for General Practitioners of...Metabolic Associated Fatty Liver Disease (MAFLD) for General Practitioners of...
Metabolic Associated Fatty Liver Disease (MAFLD) for General Practitioners of...
 
Diabetes Cases.1 Ppt
Diabetes Cases.1 PptDiabetes Cases.1 Ppt
Diabetes Cases.1 Ppt
 
Type 1 Diabetes: Dr Shahjada Selim
Type 1 Diabetes: Dr Shahjada SelimType 1 Diabetes: Dr Shahjada Selim
Type 1 Diabetes: Dr Shahjada Selim
 
approach to short stature
approach to short statureapproach to short stature
approach to short stature
 
Diabetes
DiabetesDiabetes
Diabetes
 
Diabetes Remission and Prevention
Diabetes Remission and PreventionDiabetes Remission and Prevention
Diabetes Remission and Prevention
 
Nafld management -_challenges_involved
Nafld management -_challenges_involvedNafld management -_challenges_involved
Nafld management -_challenges_involved
 
Diabetic Ketoacidosis
Diabetic KetoacidosisDiabetic Ketoacidosis
Diabetic Ketoacidosis
 
Sick day managment in diabetic children and adolescent
Sick day managment in diabetic children and adolescentSick day managment in diabetic children and adolescent
Sick day managment in diabetic children and adolescent
 
Management of dyslipidemia
Management of dyslipidemiaManagement of dyslipidemia
Management of dyslipidemia
 
Case studies in the managment of type 2 diabetes
Case studies in the managment of type 2 diabetes Case studies in the managment of type 2 diabetes
Case studies in the managment of type 2 diabetes
 
Landmark trials in diabetes
Landmark trials in diabetesLandmark trials in diabetes
Landmark trials in diabetes
 
Nafld
NafldNafld
Nafld
 
[2015] the treatment of diabetes mellitus of patients with chronic liver disease
[2015] the treatment of diabetes mellitus of patients with chronic liver disease[2015] the treatment of diabetes mellitus of patients with chronic liver disease
[2015] the treatment of diabetes mellitus of patients with chronic liver disease
 
Diabetic Ketoacidosis Case presentation
Diabetic Ketoacidosis Case presentation Diabetic Ketoacidosis Case presentation
Diabetic Ketoacidosis Case presentation
 
Management of dm in ckd
Management of dm in ckdManagement of dm in ckd
Management of dm in ckd
 

Destaque

Diabetes a brief overview for Diabetic patient
Diabetes a brief overview for Diabetic patientDiabetes a brief overview for Diabetic patient
Diabetes a brief overview for Diabetic patientDr Joozer Rangwala
 
SMBG (Self Monitoring of Blood Glucose)
SMBG (Self Monitoring of Blood Glucose)SMBG (Self Monitoring of Blood Glucose)
SMBG (Self Monitoring of Blood Glucose)Dr Joozer Rangwala
 
Maturity Onset Diabetes of the Young 3
Maturity Onset Diabetes of the Young 3Maturity Onset Diabetes of the Young 3
Maturity Onset Diabetes of the Young 3Varshil Mehta
 
Protección de las mujeres contra la violencia de genero en la argentina
Protección de las mujeres contra la violencia de genero en la argentinaProtección de las mujeres contra la violencia de genero en la argentina
Protección de las mujeres contra la violencia de genero en la argentinaMaría Isabel Sanchez
 
Що таке медичний переклад
Що таке медичний перекладЩо таке медичний переклад
Що таке медичний перекладEkaterina Glebova
 
Abc jak dziala instalacja z pompa ciepla
Abc jak dziala instalacja z pompa cieplaAbc jak dziala instalacja z pompa ciepla
Abc jak dziala instalacja z pompa cieplaabc-kotly
 
техника безопасности при работе с компьютером
техника безопасности при работе с компьютеромтехника безопасности при работе с компьютером
техника безопасности при работе с компьютеромN1ka
 
Hemsö fästning
Hemsö fästningHemsö fästning
Hemsö fästningabeltopgun
 
Abc czy potrzebna mi wentylacja mechaniczna z odzyskiem ciepla
Abc czy potrzebna mi wentylacja mechaniczna z odzyskiem cieplaAbc czy potrzebna mi wentylacja mechaniczna z odzyskiem ciepla
Abc czy potrzebna mi wentylacja mechaniczna z odzyskiem cieplaabc-kotly
 
Literate environment analysis presentation
Literate environment analysis presentationLiterate environment analysis presentation
Literate environment analysis presentationDalenAmy Morey
 

Destaque (20)

Otras Diabetes: Diabetes Tipo Lada y tipo MODY
Otras Diabetes:  Diabetes Tipo Lada y tipo MODYOtras Diabetes:  Diabetes Tipo Lada y tipo MODY
Otras Diabetes: Diabetes Tipo Lada y tipo MODY
 
Diabetes a brief overview for Diabetic patient
Diabetes a brief overview for Diabetic patientDiabetes a brief overview for Diabetic patient
Diabetes a brief overview for Diabetic patient
 
Diet and exercise in diabetes
Diet and exercise in diabetesDiet and exercise in diabetes
Diet and exercise in diabetes
 
SMBG (Self Monitoring of Blood Glucose)
SMBG (Self Monitoring of Blood Glucose)SMBG (Self Monitoring of Blood Glucose)
SMBG (Self Monitoring of Blood Glucose)
 
Maturity Onset Diabetes of the Young 3
Maturity Onset Diabetes of the Young 3Maturity Onset Diabetes of the Young 3
Maturity Onset Diabetes of the Young 3
 
Health 2.0
Health 2.0 Health 2.0
Health 2.0
 
Monogenic diabetes
Monogenic diabetesMonogenic diabetes
Monogenic diabetes
 
Protección de las mujeres contra la violencia de genero en la argentina
Protección de las mujeres contra la violencia de genero en la argentinaProtección de las mujeres contra la violencia de genero en la argentina
Protección de las mujeres contra la violencia de genero en la argentina
 
Що таке медичний переклад
Що таке медичний перекладЩо таке медичний переклад
Що таке медичний переклад
 
Abc jak dziala instalacja z pompa ciepla
Abc jak dziala instalacja z pompa cieplaAbc jak dziala instalacja z pompa ciepla
Abc jak dziala instalacja z pompa ciepla
 
техника безопасности при работе с компьютером
техника безопасности при работе с компьютеромтехника безопасности при работе с компьютером
техника безопасности при работе с компьютером
 
Myfive
MyfiveMyfive
Myfive
 
Presentm4
Presentm4Presentm4
Presentm4
 
Presentacion 0000001
Presentacion 0000001Presentacion 0000001
Presentacion 0000001
 
Hemsö fästning
Hemsö fästningHemsö fästning
Hemsö fästning
 
Abc czy potrzebna mi wentylacja mechaniczna z odzyskiem ciepla
Abc czy potrzebna mi wentylacja mechaniczna z odzyskiem cieplaAbc czy potrzebna mi wentylacja mechaniczna z odzyskiem ciepla
Abc czy potrzebna mi wentylacja mechaniczna z odzyskiem ciepla
 
La tecnologia esperanzadora
La tecnologia esperanzadoraLa tecnologia esperanzadora
La tecnologia esperanzadora
 
How to phrase your
How to phrase yourHow to phrase your
How to phrase your
 
Literate environment analysis presentation
Literate environment analysis presentationLiterate environment analysis presentation
Literate environment analysis presentation
 
Crisis
CrisisCrisis
Crisis
 

Semelhante a LADA: Latent Autoimmune Diabetes in Adults

Family Medicine Mini-OSCE exams juh.pptx
Family Medicine Mini-OSCE exams juh.pptxFamily Medicine Mini-OSCE exams juh.pptx
Family Medicine Mini-OSCE exams juh.pptxAlaaJaibat1
 
GDM :Gestational Diabetes Mellitus
GDM :Gestational Diabetes MellitusGDM :Gestational Diabetes Mellitus
GDM :Gestational Diabetes MellitusDr Joozer Rangwala
 
Acute complications of diabetes mellitus
Acute complications of diabetes mellitusAcute complications of diabetes mellitus
Acute complications of diabetes mellitusGofasefer
 
Approach to Pediatric Hypoglycemia
Approach to Pediatric HypoglycemiaApproach to Pediatric Hypoglycemia
Approach to Pediatric HypoglycemiaPediatrics
 
Investagtion and diagnosis of diabetes
Investagtion and diagnosis of diabetesInvestagtion and diagnosis of diabetes
Investagtion and diagnosis of diabetesMaryam Al-Ezairej
 
DIABETES Y ENFERMEDAD CARDIOVASCULAR 23NOVIEMBRE18
DIABETES Y ENFERMEDAD CARDIOVASCULAR   23NOVIEMBRE18 DIABETES Y ENFERMEDAD CARDIOVASCULAR   23NOVIEMBRE18
DIABETES Y ENFERMEDAD CARDIOVASCULAR 23NOVIEMBRE18 CRISTOBAL MORALES PORTILLO
 
VECHAS CHARLE'S CASE PRESENTATION.pptx
VECHAS CHARLE'S CASE PRESENTATION.pptxVECHAS CHARLE'S CASE PRESENTATION.pptx
VECHAS CHARLE'S CASE PRESENTATION.pptxKubamBranndone
 
Diabetes Diagnosis and Classification
Diabetes Diagnosis and ClassificationDiabetes Diagnosis and Classification
Diabetes Diagnosis and ClassificationDR. VIVEK ARYA
 
FCPD: Fibro Calculus Pancreatic Diabetes
FCPD: Fibro Calculus Pancreatic DiabetesFCPD: Fibro Calculus Pancreatic Diabetes
FCPD: Fibro Calculus Pancreatic DiabetesDr Joozer Rangwala
 
Diabetes Mellitus_230826_193537.pdf detail
Diabetes Mellitus_230826_193537.pdf detailDiabetes Mellitus_230826_193537.pdf detail
Diabetes Mellitus_230826_193537.pdf detailOmpriyaS
 
Case study-metabolic-syndrome-myerson
Case study-metabolic-syndrome-myersonCase study-metabolic-syndrome-myerson
Case study-metabolic-syndrome-myersonDeb Wolf
 
Paediatrics Clinicopathological Conference - Approach to a Child with Pallor
Paediatrics Clinicopathological Conference - Approach to a Child with PallorPaediatrics Clinicopathological Conference - Approach to a Child with Pallor
Paediatrics Clinicopathological Conference - Approach to a Child with PallorAzizul Halid, MBBS
 
Diabetes Melitus (Kencing Manis)
Diabetes Melitus (Kencing Manis)Diabetes Melitus (Kencing Manis)
Diabetes Melitus (Kencing Manis)Ferdiansah Umar
 

Semelhante a LADA: Latent Autoimmune Diabetes in Adults (20)

Type 1 Diabetes Mellitus
Type 1 Diabetes MellitusType 1 Diabetes Mellitus
Type 1 Diabetes Mellitus
 
Family Medicine Mini-OSCE exams juh.pptx
Family Medicine Mini-OSCE exams juh.pptxFamily Medicine Mini-OSCE exams juh.pptx
Family Medicine Mini-OSCE exams juh.pptx
 
Type 2 Diabetes Mellitus
Type 2 Diabetes MellitusType 2 Diabetes Mellitus
Type 2 Diabetes Mellitus
 
GDM :Gestational Diabetes Mellitus
GDM :Gestational Diabetes MellitusGDM :Gestational Diabetes Mellitus
GDM :Gestational Diabetes Mellitus
 
Pathology of Diabetes
Pathology of DiabetesPathology of Diabetes
Pathology of Diabetes
 
Acute complications of diabetes mellitus
Acute complications of diabetes mellitusAcute complications of diabetes mellitus
Acute complications of diabetes mellitus
 
Dyslipidemia
DyslipidemiaDyslipidemia
Dyslipidemia
 
Approach to Pediatric Hypoglycemia
Approach to Pediatric HypoglycemiaApproach to Pediatric Hypoglycemia
Approach to Pediatric Hypoglycemia
 
Investagtion and diagnosis of diabetes
Investagtion and diagnosis of diabetesInvestagtion and diagnosis of diabetes
Investagtion and diagnosis of diabetes
 
Dr Rajkumar
Dr Rajkumar Dr Rajkumar
Dr Rajkumar
 
DIABETES Y ENFERMEDAD CARDIOVASCULAR 23NOVIEMBRE18
DIABETES Y ENFERMEDAD CARDIOVASCULAR   23NOVIEMBRE18 DIABETES Y ENFERMEDAD CARDIOVASCULAR   23NOVIEMBRE18
DIABETES Y ENFERMEDAD CARDIOVASCULAR 23NOVIEMBRE18
 
VECHAS CHARLE'S CASE PRESENTATION.pptx
VECHAS CHARLE'S CASE PRESENTATION.pptxVECHAS CHARLE'S CASE PRESENTATION.pptx
VECHAS CHARLE'S CASE PRESENTATION.pptx
 
Diabetes Diagnosis and Classification
Diabetes Diagnosis and ClassificationDiabetes Diagnosis and Classification
Diabetes Diagnosis and Classification
 
FCPD: Fibro Calculus Pancreatic Diabetes
FCPD: Fibro Calculus Pancreatic DiabetesFCPD: Fibro Calculus Pancreatic Diabetes
FCPD: Fibro Calculus Pancreatic Diabetes
 
Diabetes Mellitus_230826_193537.pdf detail
Diabetes Mellitus_230826_193537.pdf detailDiabetes Mellitus_230826_193537.pdf detail
Diabetes Mellitus_230826_193537.pdf detail
 
Case study-metabolic-syndrome-myerson
Case study-metabolic-syndrome-myersonCase study-metabolic-syndrome-myerson
Case study-metabolic-syndrome-myerson
 
Pathology of Diabetes
Pathology of DiabetesPathology of Diabetes
Pathology of Diabetes
 
Paediatrics Clinicopathological Conference - Approach to a Child with Pallor
Paediatrics Clinicopathological Conference - Approach to a Child with PallorPaediatrics Clinicopathological Conference - Approach to a Child with Pallor
Paediatrics Clinicopathological Conference - Approach to a Child with Pallor
 
Parkinsonism
ParkinsonismParkinsonism
Parkinsonism
 
Diabetes Melitus (Kencing Manis)
Diabetes Melitus (Kencing Manis)Diabetes Melitus (Kencing Manis)
Diabetes Melitus (Kencing Manis)
 

Último

Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingCall Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingNehru place Escorts
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiNehru place Escorts
 
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment BookingCall Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Bookingnarwatsonia7
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Modelssonalikaur4
 
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...rajnisinghkjn
 
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service NoidaCall Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service NoidaPooja Gupta
 
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...narwatsonia7
 
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️saminamagar
 
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbersBook Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbersnarwatsonia7
 
Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptxDr.Nusrat Tariq
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalorenarwatsonia7
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknownarwatsonia7
 
97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAAjennyeacort
 
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804  Short 1500  💋 Night 6000Ahmedabad Call Girls CG Road 🔝9907093804  Short 1500  💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000aliya bhat
 
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdfHemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdfMedicoseAcademics
 
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...narwatsonia7
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformKweku Zurek
 
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original PhotosBook Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photosnarwatsonia7
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...Miss joya
 

Último (20)

Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingCall Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
 
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Servicesauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
 
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment BookingCall Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
 
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
 
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service NoidaCall Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
 
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
 
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
 
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbersBook Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
 
Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptx
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
 
97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA
 
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804  Short 1500  💋 Night 6000Ahmedabad Call Girls CG Road 🔝9907093804  Short 1500  💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
 
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdfHemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
 
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy Platform
 
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original PhotosBook Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
 

LADA: Latent Autoimmune Diabetes in Adults

  • 1. Case 5 History: 42 yrs male presented with c/o being exhausted for past 8 month, with increased frequency of urine at night. On further inquiring he had intense thirst but no change in appetite. Past History: No major illness in past. Family History: No evidence of family history of Diabetes
  • 2. Personal History: Works as accountant, married with two children, non smoker, does not take alcohol, or any other medicines. O/E: Weight : 88 kg Height: 171 cm BMI : 30.1 kg/m2 Pulse: 80/min Regular BP : 136/84 mm of Hg Obesity CVS/RS/AS/CNS : Normal Peri Pulse: Normal felt Feet / Nails / Sensation : clinically Normal
  • 3. Laboratory Ix: 1. OGTT : with 75 gm glucose FBG : 170 mg/dL, PPBG : 310 mg/dL 2 Urine R/M: Sugar ++, Acetone: +, No proteins 3. Fundoscopy : normal 4. Hba1c: 8.9 %
  • 4. Q: 1. Based on Above History what is Provisional Diagnosis? 1. Type 1 DM 2. Type 2 DM 3. LADA 4. MODY
  • 5. Why LADA : 1. FBG, PP2BG and Hba1c : confirms Diabetes 2. Presence of Ketone's, in urine, favors Type 1 DM 3. No family history also favors Type1 DM 4. But his age favors Type 2 DM So to confirm what is required?
  • 6. Q : 2 To confirm what else is required? 1. GAD 65 2. C peptide 3. Both 1 and 2 4. None of the above.
  • 7. Analysis: His C peptide was less than normal GAD 65 was positive..... Thus confirming Type 1 DM, But his Age and onset (not acute) are against... So diagnosis is .....LADA (Latent Autoimmune Diabetes in Adult)
  • 8. What is normal value of C peptide level? 2 to 4.5 1.2 to 3.4 0.4 to 2.1 Adult 2 to 4.5 1.2 to 3.4 0.4 to 2.2 Child ( < 15 yr) PP 2 Hr level After Glucose load PP 2 Hr level After Meal Fasting level “ C” peptide level : Unit :nano gm/ml
  • 9.
  • 10.