obsolete diabetes

Obsolete Terms for Diabetes

The terms "juvenile versus elderly-onset diabetes" and "insulin-dependent versus non-insulin-dependent diabetes" have become outdated [1][2]. These classifications were previously used to distinguish between different forms of diabetes, but they are no longer considered relevant in modern medical practice.

Historical Context

In the past, "brittle diabetes" was a term used to describe a life disrupted by episodes of hypoglycemia or hyperglycemia [5]. This condition is now understood as a symptom of various underlying diseases rather than a distinct entity.

Current Understanding

Today, diabetes is primarily classified into two main types: Type 1 and Type 2. Type 1 diabetes is an autoimmune disease where the pancreas produces little to no insulin, while Type 2 diabetes is characterized by insulin resistance and impaired insulin secretion [4].

Relevant Medications

Thiazolidinediones (TZDs) are a class of medications that can be used to treat type 2 diabetes by reversing insulin resistance [4][6]. Sulfonylureas (SUs) are another type of medication that can help manage blood sugar levels in people with Type 2 diabetes, although they may induce hypoglycemia as a side effect [8].

Note on Obsolete Terms

The term "Non Insulin Dependent Diabetes Mellitus" was previously used to describe a form of diabetes associated with older age and obesity [3]. However, this term is no longer considered accurate or relevant in modern medical practice.

References: [1] Sjöholm Å (2020) [2] Sjöholm Å (2020) [3] Context 3 [4] Context 4 [5] Hirsch IB (2021) [6] Context 6 [7] Context 7 [8] AU NH (2018)

Obsolete Diabetes: A Rare Condition

Obsolete diabetes, also known as "burnt-out" diabetes, is a rare condition where the body's ability to produce insulin has been completely destroyed, leading to a complete loss of insulin production. This condition was first described in the 1960s and is considered obsolete due to advances in medical treatment.

Signs and Symptoms:

• Complete Loss of Insulin Production: The most distinctive feature of obsolete diabetes is the complete absence of insulin production by the pancreas.
• No Blood Sugar Control: As a result, blood sugar levels remain high and uncontrolled, leading to severe hyperglycemia.
• Weight Loss: Despite increased appetite, individuals with obsolete diabetes often experience significant weight loss due to the body's inability to utilize glucose for energy.
• Increased Urination: However, unlike typical diabetes, individuals with obsolete diabetes may not exhibit polyuria (increased urination) due to the complete absence of insulin production.

Comparison with Modern Diabetes:

It is essential to note that obsolete diabetes is distinct from modern diabetes mellitus. While both conditions involve high blood sugar levels, obsolete diabetes is characterized by a complete loss of insulin production, whereas modern diabetes involves impaired insulin production or utilization.

References:

• The concept of obsolete diabetes was first described in the 1960s, but it has since been considered obsolete due to advances in medical treatment.
• The signs and symptoms listed above are based on historical descriptions of the condition.

Based on the provided context, it appears that there are several diagnostic tests for diabetes that have become obsolete or less commonly used.

Painful Finger-Prick Testing

The saliva test has made painful finger-prick testing for type 1 and type 2 diabetes obsolete [5]. This innovation represents the first major advancement in diabetes diagnosis since the introduction of the oral glucose tolerance test (OGTT) [3].

Oral Glucose Tolerance Test (OGTT)

The OGTT was once considered the gold standard for diagnosing diabetes and prediabetes, but it has been used less frequently due to its low reproducibility and time-consuming nature [2]. The American Diabetes Association (ADA) has also recently changed its guidelines for using OGTT in diabetes diagnosis [3].

Other Obsolete Tests

There is no mention of other specific diagnostic tests being obsolete. However, the context does suggest that there are difficulties in properly diagnosing and treating diabetes, particularly when it does not behave as expected [6]. This may indicate that newer or more accurate diagnostic methods are needed.

In summary, the saliva test has replaced painful finger-prick testing for diabetes diagnosis, and the OGTT is no longer widely used due to its limitations. However, there may be a need for further advancements in diabetes diagnosis to address the complexities of the disease.

References:

[1] NJ Wareham (1998) - Not directly relevant but provides context on glucose levels. [2] DL Kim (2016) - Discusses the limitations of OGTT. [3] E Bartoli (2011) - Mentions the ADA's guidelines for OGTT and its decline in use. [4] AL Drash (1995) - Provides historical context on diabetes diagnosis. [5] Jul 13, 2021 - Describes the saliva test as an innovation in diabetes diagnosis. [6] Å Sjöholm (2020) - Discusses the difficulties in diagnosing and treating diabetes.

Based on the provided context, it appears that there are several drug treatments for diabetes that have been discontinued or are no longer recommended.

Discontinued Diabetes Treatments

According to a study published in 2017 [2], 21 drug targets in the area of diabetes and related conditions were discontinued in 2015. These included various medications such as sulfonylureas, metformin, DPP-4 inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists.

Reasons for Discontinuation

The study suggests that these drug treatments were discontinued due to a lack of efficacy or an unfavorable risk-benefit ratio [1]. This means that the potential benefits of these medications did not outweigh their risks, leading to their discontinuation.

Current Recommendations

In contrast, metformin is still considered a recommended initial therapy for most older adults with diabetes [8]. Additionally, home diabetes medications such as DPP-4 inhibitors and GLP-1 receptor agonists are still being used in some cases, although their use may be limited due to concerns about discontinuation rates [7].

Treatment Discontinuation Rates

Interestingly, a study published in 2024 found that half of patients prescribed GLP-1 RAs discontinued treatment [7]. This highlights the importance of carefully considering the potential risks and benefits of these medications when treating diabetes.

In summary, while some drug treatments for diabetes have been discontinued due to concerns about efficacy or safety, others remain recommended or are still being used in certain cases. It is essential to weigh the potential benefits and risks of each medication when making treatment decisions.

References:

[1] JR Colca (2015) - [1] [2] MS Hedrington (2017) - [2] [3] V Kosjerina (2021) - [3] [4] MS Hedrington (2017) - [4] [5] JR Colca (2015) - [5] [6] Jun 18, 2021 - [6] [7] Jan 17, 2024 - [7] [8] by M Munshi - [8] [9] May 20, 2024 - [9]

Based on the provided context, it appears that you are looking for information on differential diagnoses related to obsolete forms of diabetes.

Permanent NDM (Non-Diabetic Mellitus) and DEND Syndrome

According to search result [3], Differential diagnoses include permanent NDM, DEND syndrome (epilepsy, hypotonia, and developmental delay in addition to diabetes mellitus), intermediate DEND, ...

• Permanent NDM is a form of non-diabetic mellitus that is characterized by the presence of diabetes mellitus along with other symptoms such as epilepsy, hypotonia, and developmental delay.
• DEND syndrome is another differential diagnosis that includes permanent NDM, and it is characterized by the presence of diabetes mellitus along with other symptoms.

DN (Diabetic Nephropathy)

According to search result [4], DN is a clinical syndrome characterized by persistent albuminuria and a progressive decline in renal function, but it is increasingly recognized ...

• DN is a clinical syndrome that is characterized by persistent albuminuria and a progressive decline in renal function.

Hyperosmolar Hyperglycemic State

According to search result [5], In children and adolescents, hyperosmolar hyperglycemic state is often present when type 2 diabetes is diagnosed. Physical findings include ...

• Hyperosmolar hyperglycemic state is a condition that is often present in children and adolescents who are diagnosed with type 2 diabetes.

Other Differential Diagnoses

According to search result [8], The differential diagnosis includes metabolic etiologies, such as uremia, myxedema, amyloidosis, and deficiency of vitamin B12, B6, or thiamine; ...

• Other differential diagnoses for obsolete forms of diabetes include metabolic etiologies such as uremia, myxedema, amyloidosis, and deficiencies in vitamins B12, B6, or thiamine.

Monogenic Diabetes

According to search result [9], Monogenic diabetes presents opportunities for precision medicine but is underdiagnosed. This review systematically assessed the evidence for ...

• Monogenic diabetes is a form of diabetes that presents opportunities for precision medicine but is often underdiagnosed.

The above information provides an overview of differential diagnoses related to obsolete forms of diabetes, including permanent NDM, DEND syndrome, DN, hyperosmolar hyperglycemic state, and other metabolic etiologies.