Special forms of diabetes mellitus and their treatment. Gestational diabetes mellitus
1. Big picture
Most diabetes is type 1 or type 2, but the examiner wants you to recognize the atypical diabetes patient:
Young, non-obese, strong family history → think MODY. Adult “type 2” patient who becomes insulin-dependent quickly → think LADA. Diabetes after pancreatitis/pancreatectomy/cystic fibrosis → think pancreatogenic diabetes. New hyperglycemia after steroids/transplant drugs/endocrine excess → think secondary diabetes. Pregnant woman with abnormal glucose tolerance → think gestational diabetes mellitus (GDM).
The clinical reason this matters: the treatment changes. Some forms need insulin, some respond dramatically to sulfonylureas, some require treating the underlying disease, and pregnancy requires very strict glucose targets to protect the fetus.
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