1 Type 2 diabetes: epidemiology, complications and costs EPIDEMIOLOGY Changes in lifestyle over the past century have resulted in a dramatic increase in the incidence of type 2 diabetes worldwide….
7 Organisation of diabetes care ROLE OF THE PRIMARY CARE TEAM IN MULTI-PROFESSIONAL CARE An important consequence of a chronic condition such as type 2 diabetes is that it is…
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Fig. 2.1 Steroid biosynthetic pathways in the human adrenal cortex. Shown are enzymes (underlined) and intermediates in the biosynthesis of adrenal steroid hormones. 17α-Hydroxypregnenolone is the preferred substrate for the…
Aldosterone-producing adenoma (APA)—30% of cases Bilateral idiopathic hyperplasia (IHA)—60% of cases Primary (unilateral) adrenal hyperplasia—2% of cases Aldosterone-producing adrenocortical carcinoma—<1% of cases Familial hyperaldosteronism (FH) Glucocorticoid-remediable aldosteronism (FH type 1)—<1%…
Gene or marker Population Number of patients Odds ratio P value MHC loci HLA-B*08 Norway [66] 414 2.6 4 × 10−11 HLA-DR3-DQ2 Norway [67] 94 3.6 <10−7 HLA-DR3-DQ2 Finland, Russia, Estonia [68]…
Symptoms Frequency Signs Frequency Headache ++++ Hypertension ++++ Palpitations +++ – Sustained ++ Sweating +++ – Paroxysmal ++ Anxiety/nervousness ++ Tachycardia or reflex bradycardia +++ Abdominal/chest pain ++ Sweating/diaphoresis +++ Nausea ++…
Primary Genetic disorders Congenital adrenal hyperplasia Adrenoleukodystrophy ACTH resistance syndromes ACTH insensitivity: familial glucocorticoid deficiency, triple-A syndrome Adrenal hypoplasia congenita Other transcription factors: SF1 (NR5A1) Drug induced Adrenostatic/adrenolytic: etomidate, ketoconazole,…
Mild hypercortisolism Overt hypercortisolism Diagnostic tests Sensitivity/specificity DSTa 75–100%/67–72% 100%/91% UFCb 36% 97%/91% MSCc 82%/60% 92–100%/93–100% Frequent mutations d Genetic mutations CTNNB1 (16%) ARMC5 (55% of BMAH)e PRKACA (35–69%)…
Fig. 1.1 Concentric layers of the mouse adrenal gland. (a) Schematic of the various regions of the adrenal. (b) A representative H&E longitudinal mouse adrenal section. Zones are identified by…
