Other Syndromes

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Syndromes involving chromosomes (Down, Klinefelter's), fat and muscle metabolism (Prader-Willi, myotonic dystrophy), and autoimmune mechanisms (stiff man syndrome) can affect insulin secretion or sensitivity.

Inflammatory attack

Aging, 1° IR or 2° excess nutrient storage

Figure 34-1 How normal or genetically impaired beta cells can be affected by inflammation and overnutrition, resulting in absolute or relative loss of insulin secretory reserve and the activation of the common mechanism leading to diabetic crisis. 1°IR, Primary insulin resistance; 2°IR, secondary insulin resistance; DKA, diabetic ketoacidosis; FFA, free fatty acids; TRG, triglycerides.

Figure 34-1 How normal or genetically impaired beta cells can be affected by inflammation and overnutrition, resulting in absolute or relative loss of insulin secretory reserve and the activation of the common mechanism leading to diabetic crisis. 1°IR, Primary insulin resistance; 2°IR, secondary insulin resistance; DKA, diabetic ketoacidosis; FFA, free fatty acids; TRG, triglycerides.

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