2008 Clinical Practice Guidelines - Canadian Diabetes Association

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2008 CLINICAL PRACTICE GUIDELINES S194 Appendix 1 Etiologic Classification of Diabetes Mellitus * Type 1 diabetes mellitus Beta cell destruction, usually leading to absolute insulin deficiency • Immune-mediated • Idiopathic Type 2 diabetes mellitus May range from predominant insulin resistance with relative insulin deficiency to predominant secretory defect with insulin resistance Genetic defects of beta cell function • Chromosome 20, HNF-4alpha (formerly MODY1) • Chromosome 7, glucokinase (formerly MODY2) • Chromosome 12, HNF-1alpha (formerly MODY3) • Chromosome 13, IPF-1 (formerly MODY4) • Chromosome 17, HNF-1beta (MODY5) • Chromosome 2, NeuroD1 (MODY6) • Mitochondrial DNA • Neonatal diabetes (e.g. due to Kir6.2 mutation) • Others Genetic defects in insulin action • Leprechaunism • Lipoatrophic diabetes • Rabson-Mendenhall syndrome • Type A insulin resistance • Others Diseases of the pancreas • Cystic fibrosis • Fibrocalculous pancreatopathy • Hemochromatosis • Neoplasia • Pancreatitis • Trauma/pancreatectomy • Others Endocrinopathies • Acromegaly • Aldosteronoma • Cushing syndrome • Glucagonoma • Hyperthyroidism • Pheochromocytoma • Somatostatinoma • Others Gestational diabetes mellitus Onset or first recognition of glucose intolerance during pregnancy Other specific types Infections • Congenital rubella • Cytomegalovirus • Others Uncommon forms of immune-mediated diabetes • Anti-insulin receptor antibodies • “Stiff-man” syndrome • Others Drug- or chemical-induced • Atypical antipsychotics • Beta-adrenergic agonists • Cyclosporine • Diazoxide • Glucocorticoids • Interferon alfa • Nicotinic acid • Pentamidine • Phenytoin • Protease inhibitors • Thiazide diuretics • Thyroid hormone • Others Other genetic syndromes sometimes associated with diabetes • Down syndrome • Friedreich ataxia • Huntington chorea • Klinefelter syndrome • Laurence-Moon-Bardet-Biedl syndrome • Myotonic dystrophy • Porphyria • Prader-Willi syndrome • Turner syndrome • Wolfram syndrome • Others *Patients with any form of diabetes may require insulin treatment at some stage of their illness. Such use of insulin does not, of itself, classify the patient HNF = hepatocyte nuclear factor IPF = insulin promoter factor MODY = maturity-onset diabetes of the young Adapted with permission from: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2007;30(suppl 1):S42-S47.
Appendix 2. Sample Diabetes Patient Care Flow Sheet for Adults SEE REVERSE FOR CARE OBJECTIVES AND TARGETS 2008 CLINICAL PRACTICE GUIDELINES Name Type 1 ❑ Type 2 ❑ Age at diagnosis Date of birth Care objectives (risk factors, comorbidities) Self-management (discuss with patient) ❑ Hypertension (target
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2008 Clinical Practice Guidelines - Canadian Diabetes Association

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