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Diabetes type 3. What?
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Diabetes type 3. What?
Discuss any aspect of type I or type II diabetes mellitus here
Diabetes gurus, I'm getting referrals for pre-op. assessement from surgeons alarmed by a diagnosis of "type 3 diabetes"   Me, too.   I have googled and found three different d
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Forums » Open clinical » Diabetes » Diabetes type 3. What?

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Forums  »  Open clinical  »  Diabetes  »  Diabetes type 3. What?

Diabetes type 3. What?

posted at 10/11/2011 3:46 PM GMT on bmj.com
Posts: 2052
First: 12/3/2010
Last: 23/5/2013
Diabetes gurus,

I'm getting referrals for pre-op. assessement from surgeons alarmed by a diagnosis of "type 3 diabetes"   Me, too.   I have googled and found three different descriptions:

1/ The development of type 2 in someone who already has type 1, "double diabetes"
http://www.lifescript.com/health/centers/diabetes/articles/the_double_whammy_what_is_type_3_diabetes.aspx
2/ Diabetes due to the failure of insulin secreting tissue in the brain, "brain diabetes"
http://www.diabetes.co.uk/type3-diabetes.html
3/ Diabetes due to "electropollution" - cell phones, radio waves, high tension transmission lines etc.
http://www.naturalnews.com/028967_electropollution_diabetes.html

Even discounting the last one as a diagnosis only heard from someone who wears an oven-foil hat in bed, I'm at a loss to know what "type 3" is.  Let alone if it needs any special care in the perioperative period, which I doubt.

Lighten my darkness, O oracles!

John

Re: Diabetes type 3. What?

posted at 10/11/2011 5:48 PM GMT on bmj.com
DrS
Posts: 1348
First: 25/1/2009
Last: 20/5/2013
As I understand the diabetes associated with cystic fibrosis is Type 3b diabetes and Gestational diabetes is classified as type 4! I never quite understood why???

Re: Diabetes type 3. What?

posted at 10/11/2011 11:00 PM GMT on bmj.com
Posts: 624
First: 13/4/2011
Last: 15/5/2013
Hello John D:

Great question!

Let-me try to make it understandable in a few words, even because there are not many data or studies about that, but it looks like it is for real.

Many Type 1 diabetics later or sooner than expected, on their life history, become great food consumers and get overweight or even obese. So, now they have insulin deficiency from previous type 1 diabetes plus insulin resistance secondary to excess weight/obesity. Some people call it type 1 getting into type 2, others call it type 3 diabetes.

So, there are nowadays an increasiing number of children/adolescents/adults with type 1 diabetes that become obese/insulin resistant and also become type 2 diabetics.

These people should also, because of excess weight/obesity, have a higher cardiovascular/respiratory peri-operative risk. You should be more careful with them.

This is how I see this issue,.

All Best,

Joey

Re: Diabetes type 3. What?

posted at 11/11/2011 1:44 PM GMT on bmj.com
Posts: 453
First: 29/4/2011
Last: 14/5/2013

Joey is quite right. Unfortunately people with type 1 diabetes are not immune to the current obesity epidemic.  When obesity complicates type 1 diabetes they become insulin resistant and more subject to cardiovascular disease.  As far as I can see type 3 diabetes because if brain insulin deficiency is a rhetorical construct with no current clinical implication.  The third definition is more metaphysical than medical.

Re: Diabetes type 3. What?

posted at 11/11/2011 1:56 PM GMT on bmj.com
DrS
Posts: 1348
First: 25/1/2009
Last: 20/5/2013
In Response to Re: Diabetes type 3. What?:
Joey is quite right. Unfortunately people with type 1 diabetes are not immune to the current obesity epidemic.  When obesity complicates type 1 diabetes they become insulin resistant and more subject to cardiovascular disease.  As far as I can see type 3 diabetes because if brain insulin deficiency is a rhetorical construct with no current clinical implication.   The third definition is more metaphysical than medical.
Posted by diabetesMD


Perhaps you can confirm for me... Where do diabetes such as gestational diabetes, CF diabetes and conditions such as DIDMOAD (wolfram's syndrome) fit into the classification system???

Diagnosis and Classification of Diabetes

posted at 11/11/2011 7:28 PM GMT on bmj.com
Posts: 453
First: 29/4/2011
Last: 14/5/2013
The 1999 report from the WHO only defined four tipes of diabetes:
Type 1
Type 2
Other types of diabetes
Gestational diabetes
Definition, diagnosis and classification of diabetes mellitus and its complications [pdf 1741kb]
Report of a WHO consultation, Part 1: Diagnosis and classification of diabetes mellitus, Geneva, 59p, WHO/NCD/NCS/99.2
So except for gestational diabetes the other types of diabetes that you mentioned who be named individually such as, for instance,  the various forms of MODY or drug-induced diabetes.

Re: Diabetes type 3. What?

posted at 15/11/2011 9:50 PM GMT on bmj.com
Posts: 624
First: 13/4/2011
Last: 15/5/2013
An important clinical issue in "type 3 diabetes":

When those type 1 individuals become overweight/obese they start needing more units of insulin/day because of this acquired insulin resistance.

This increased insulin dose also adds further weight gains... So, it´s a really messy vicious circle.

All Best,

Joey

Re: Diabetes type 3. What?

posted at 15/11/2011 10:44 PM GMT on bmj.com
Posts: 2052
First: 12/3/2010
Last: 23/5/2013
Thanks, gurus!

Glad to have the brain idea scotched and my prejudices about electropollution confirmed.
I think for my purposes, perioperative DM control, I'll treat Type 3 as Type 1.

John

Re: Diabetes type 3. What?

posted at 16/11/2011 2:51 PM GMT on bmj.com
Posts: 624
First: 13/4/2011
Last: 15/5/2013
Hello John:

I think it´s a good idea to see these patients as overall sicker than the usual type 1 diabetics.


All Best,

Joey

Re: Diabetes type 3. What?

posted at 18/11/2011 12:07 PM GMT on bmj.com
Posts: 18
First: 28/1/2011
Last: 30/4/2013
Haha, as they say in this part of the world "sweet, too sweet!"
Now, if the pure Type 2 progresses to complete lack of insulin secretion, does he become a Type 2 who has developed Type 1? And will this be called Type 4?!!

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Forums » Open clinical » Diabetes » Diabetes type 3. What?