Basic aspects
Learn the basic concepts first, before moving on to more complex matters.
Pancreatic diabetes
π§ What is diabetes secondary to pancreatic diseases?
π§ How does chronic pancreatitis cause diabetes?
π§ Why does pancreatic cancer cause diabetes?
π§ What is type 3c diabetes and how do you recognize it?
π§ How does cystic fibrosis affect the pancreas?
π§ Will you always have diabetes after pancreatectomy?
π§ Why does hemochromatosis destroy the pancreas?
π§ Can acute pancreatitis cause permanent diabetes?
π§ How does pancreatic diabetes differ from type 1 or 2?
π§ What tests confirm pancreatic origin?
Endocrine diabetes
π§ How does Cushing's disease cause diabetes?
π§ Why does acromegaly increase blood glucose?
π§ Can hyperthyroidism cause diabetes?
π§ How does pheochromocytoma affect blood glucose?
π§ What is glucagonoma and how does it affect blood glucose?
π§ Why does aldosteronism disturb glucose metabolism?
π§ Can somatostatinoma cause diabetes?
π§ How does polycystic ovary syndrome affect blood glucose?
π§ What pituitary disorders produce secondary diabetes?
π§ Is diabetes reversible after treating the endocrine cause?
Drug-induced diabetes
π§ Which corticosteroids most commonly cause diabetes?
π§ How do statins cause blood glucose increase?
π§ Why do thiazide diuretics affect blood glucose?
π§ Can beta-blockers induce diabetes?
π§ Which immunosuppressants cause post-transplant diabetes?
π§ How do antipsychotics affect glucose metabolism?
π§ Why can HIV therapy cause diabetes?
π§ Is diabetes reversible after stopping medications?
π§ Which cancer medications induce hyperglycemia?
π§ How do you monitor blood glucose under corticosteroid therapy?
Genetic and syndromic diabetes
π§ What is MODY diabetes and how is it inherited?
π§ How do you recognize mitochondrial diabetes?
π§ What genetic syndromes include diabetes?
π§ Can Down syndrome be associated with diabetes?
π§ What is Wolfram syndrome with diabetes?
π§ How does AlstrΓΆm syndrome manifest?
π§ What genetic mutations cause neonatal diabetes?
π§ Is MODY diabetes treated differently?
π§ Do all family members need genetic testing?
π§ How do you differentiate MODY from type 1 diabetes?
Secondary diabetes diagnosis
π§ What tests differentiate secondary diabetes from other forms?
π§ When do you suspect that diabetes is not type 1 or 2?
π§ What medical history suggests secondary diabetes?
π§ How do you investigate exocrine pancreatic function?
π§ What tumor markers do you check in new-onset diabetes?
π§ We screen everyone for secondary causes?
π§ What imaging helps diagnose the cause?
π§ How do you test endogenous insulin reserve?
π§ What hormonal tests are necessary?
π§ When do you refer to a geneticist for diabetes?
Evaluation and classification
π§ How do you correctly classify the type of secondary diabetes?
π§ What criteria do you use for differential diagnosis?
π§ Can secondary diabetes coexist with other types?
π§ How do you document the cause of secondary diabetes?
π§ What specialists do you consult for complete evaluation?
π§ When do you revise the diabetes diagnosis?
π§ What protocol do you follow for complex cases?
π§ How do you differentiate the primary from the secondary cause?
π§ Is it important to identify the exact cause?
π§ What implications does the diagnosis have for family?
Treatment and management
Managing secondary diabetes for optimal glycemic control
Cause-specific treatment
π§ How do you treat diabetes from chronic pancreatitis?
π§ What pancreatic enzymes need supplementation?
π§ Does tumor resection improve diabetes?
π§ How do you manage post-surgical diabetes?
π§ Does diabetes improve after treating Cushing's syndrome?
π§ What do you do when you can't stop corticosteroids?
π§ How do you adapt treatment to the underlying disease?
π§ Do all patients with pancreatic diabetes receive insulin?
π§ When do you use GLP-1 analogs in secondary diabetes?
π§ How do you treat diabetes and its cause simultaneously?
Glycemic management
π§ Why is control more difficult in secondary diabetes?
π§ What are realistic glycemic targets?
π§ How do you adjust treatment to high variability?
π§ What insulin regimens work best?
π§ Can you use oral medications in pancreatic diabetes?
π§ How do you prevent frequent hypoglycemia?
π§ Why do you need high insulin doses?
π§ How do you manage severe insulin resistance?
π§ What do you do when blood glucose is very unstable?
π§ Is an insulin pump worthwhile in secondary diabetes?
Specific monitoring
π§ What additional parameters do you monitor?
π§ How do you track the evolution of the underlying disease?
π§ How often do you do pancreatic imaging?
π§ What functional tests do you repeat periodically?
π§ How do you detect specific complications?
π§ Do pancreatic diabetes need oncological follow-up?
π§ What inflammatory markers do you check?
π§ How do you monitor residual endocrine function?
π§ What genetic screening do you offer to family?
π§ When do you intensify monitoring?
Nutrition and digestion
π§ What diet do you follow with pancreatic insufficiency?
π§ How do you compensate for nutrient malabsorption?
π§ Why do you need fat-soluble vitamins?
π§ How do you manage steatorrhea from pancreatitis?
π§ What foods do you avoid in pancreatic diabetes?
π§ Do all patients need digestive enzyme supplements?
π§ How do you prevent malnutrition in secondary diabetes?
π§ What do you do for chronic abdominal pain?
π§ How do you adapt diet to individual tolerance?
π§ When is parenteral nutrition necessary?
Specific complications
π§ Why do complications appear faster in secondary diabetes?
π§ How do you prevent osteoporosis from malabsorption?
π§ What is the risk of pancreatic cancer in pancreatitis?
π§ How do you manage chronic pancreatic pain?
π§ Why do you have increased risk of severe hypoglycemia?
π§ Can secondary diabetes cause ketoacidosis?
π§ How does malnutrition affect wound healing?
π§ What complications does chronic corticosteroid therapy bring?
π§ How do you monitor neuropathy in genetic diabetes?
π§ Why do microvascular complications progress rapidly?
Special care aspects
π§ How do you manage diabetes during frequent hospitalizations?
π§ What preparation do surgical interventions require?
π§ How do you ensure continuity of care?
π§ What psychological support is necessary?
π§ How do you involve family in management?
π§ What community resources are available?
π§ How do you access specialized treatments?
π§ What rehabilitation programs exist?
π§ When do you consider palliative care?
π§ How do you plan long-term care?