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Diabetes Mellitus Endocrinology Department, Renji Hospital 陶 弢 LADA– Clinical feature Called type 1.5 DM or slowly progressing insulin-dependent diabetes T cell mediated autoimmune disease Adult age at diagnosis (range 30-70year) Lean or non-obesity The presence of diabetes-associated autoantibodies(IA2, ICA, GAD ) Delay (at least half year )from diagnosis in the need for insulin therapy to manage hyperglycemia Having type 1 DM’s predisposing genes( such as HLA-DR3,HLA-DR4,BW54, DQ-131-57-NON-ASP etal) Often accompany thyroid and gastric parietal cells organ specific antibody MODY Clinical feature Early onset, at least one patient develops Diabetes before the age of 25 Autosomal Dominant Inheritance , disease deliver fit Mendelian inheritance ; having three generation or above family constellation heredity history Diabetes may be treated by diet or tablets and does not always need insulin treatment Mitochondrial maternal inheritance diabetes clinical feature Maternal inheritance; means children of female patient possible with disease, children of male patient not with disease Early onset, Lean or non-obesity Diabetes may be treated by diet or tablets and does not always need insulin treatment at initial stage, no prone to ketosis; but in the long run, need for insulin therapy to manage hyperglycemia Often accompany dysaudia in prediabetes or afterdiabetes Minority having manifestation damaged by (nerve, muscle, retina hematopoietic system, et al) or serum lactic acid raising up Other specific types Genetic defects of insulin action Type A insulin resistance( ovarian hyperandrogen insulin resistant acanthosis nigrican HAIR-AN ) Rabson-Mendenhall syndrome Leprechaunism Lipoatrophic diabetes Disease of exocrine pancreas Endocrinopathies Drug or chemical-induced Infections Uncommon forms of immune-mediated diabetes Other