Juvenile onset

There are multiple causes of diabetes. Whereas the molecular bases of some forms of diabetes are well understood, in many cases etiologies are unknown. It is customary to divide diabetes into two main forms insulin-dependent diabetes mellitus (IDDM), also referred to as Type I or juvenile-onset diabetes, and noninsulin-dependent diabetes mellitus (NIDDM), also called Type II or maturity-onset diabetes (3). 

Kugelberg-Welander disease (type III SMA) is characterized by juvenile onset and prolonged survival. In early stages of the disease the process of reinnervation... 

Human insulin Two peptide chains A, 21 amino acids long, and B, 30 amino acids long . coli Juvenile onset diabetes Approved for sale A and B chains made separately as fusion proteins and joined in vitro Compared with animal Insulins some undesirable side-effects have been noted... 

HF Heart failure JODM juvenile-onset diabetes mellitus... 

Failure of the body to synthesize sufficient insulin results in the development of insulin-dependent diabetes mellitus (IDDM). This is also known as type-1 diabetes or juvenile-onset diabetes. 

In both types of diabetes, however, this normal process malfunctions. A gland called the pancreas, found just behind the stomach, makes insulin. In people with insulin-dependent diabetes, the pancreas does not produce insulin at all. This condition usually begins in childhood and is known as Type I (formerly called juvenile-onset) diabetes. These patients must have daily insulin injections to survive. People with non-insulin-dependent diabetes usually produce some insulin in their pancreas, but their bodies tissues do not respond well to the insulin signal and, therefore, do not metabolize the glucose properly, a condition known as insulin resistance. 

Type 1 Autoimmune disease resulting in an absolute deficiency of insulin. Formerly referred to as juvenile onset diabetes, type I DM or insulin dependent diabetes mellitus (IDDM). Ketosis is common in poorly controlled subjects. 

Huntington s disease, an autosomal dominant disorder, has a mean age-of-onset of 43-48 years. Symptoms appear gradually and worsen over a period of about 15 years until death occurs. Mood disturbance, impaired memory, and hyperrefiexia are often the first signs, followed by abnormal gait, chorea (loss of motor control), dystonia, dementia, and dysphagia. Cases of juvenile onset (<10 years old) are more severe and most frequently occur when the defective allele is inherited paternaily. About 25% of cases have late onset, slower progression, and milder symptoms. 

Juvenile onset (type I) diabetes mellitus is caused by the destruction of insulin-producing B cells in the pancreas, necessitating replacement of insulin (daily dose approx. 40 U, equivalent to approx. 1.6 mg). 

Diabetes mellitus has been traditionally classified into insulin-dependent diabetes mellitus (IDDM), also known as type I (formerly called juvenile-onset diabetes mellitus), and non-insulin-dependent diabetes mellitus (NIDDM), also known as type II (formerly referred to as adult-onset diabetes mellitus). There are clearly varying degrees of overlap, and though it is often important to know whether a particular individual possesses relative insulin deficiency or relative insulin resistance or both, some of the more salient differences between IDDM and NIDDM are summarized in Table 67.1. 

Hollis, C. (1995) Child and adolescent (juvenile onset) schizophrenia a case-control study of premorbld developmental impairments. Br J Psychiatry 166 489-495. 

Diagnostic boundaries in juvenile-onset BD need to be defined, since children with hypomania or manic-like symptoms may be increasingly treated with mood stabilizers. In parallel, this would require more complex algorithms because very few controlled trials have been reported (Walkup, 1995). In contrast to the studies of adults reported in the literature, the pharmacological treatment of childhood bipolarity with anticonvulsants remains an understudied area. Carbamazepine appears to be less efficacious than valproate in adult rapid cycling, yet no studies have identified predictors of treatment response to CBZ or any other mood stabilizer (besides lithium) in a pediatric population. 

Woolston, J.L. (1999) Case study carbamazepine treatment of juvenile-onset bipolar disorder. / Am Acad Child Adolesc Psychiatry 38 335-338. 

Insulin dependent or type I diabetes (IDDM). Formerly called juvenile onset, or ketone prone diabetes. It is an autoimmune disease of pancreatic (3-cells. Arises due to insulin insufficiency. 

In type I (juvenile onset) diabetes mellitus, the inability to release insulin (and thus to mobilize glucose... 

Finally, membrane proteins are also increasingly glycosylated in diabetes (65). Reid, et al. (68) recently identified an anti-M alloagglutinin in juvenile-onset diabetes that would agglutinate M-positive cells that had been pre-incubated in glucose. This suggests that Amadori products could act as haptens and elicit an immune reaction towards glycosylated tissues. 

Figure 4. TOP The amount of keto amine-linked glycosylation of insoluble collagen plotted as a function of subject s age. BOTTOM The amount of insoluble collagen plotted as a function of subject s age. Key O. normal +, juvenile-onset diabetic and , maturity-onset diabetic.

As mentioned in Chapter 1, perhaps the purest form of drug therapy is the replacement of inadequate amounts of an endogenous substance such as a hormone. Any gland that normally secretes a hormone is a potential target for hypofunctioning. Classical examples include Addison s disease (adrenal cortex), dwarfism (anterior pituitary), juvenile-onset insulin-dependent diabetes (pancreas), and hypothyroidism (thyroid). 

Diabetes mellitus has been diagnosed in approximately 14 million people in the United States. Of these, 10-20 percent are classified as having insulin-dependent, juvenile-onset (type 1) while the remainder have non-insulin-dependent, maturity-onset (type 2). However, the situation can be somewhat more complex than these straightforward definitions in that type 1 can occur at any age and type 2 can require the use of insulin. At the present time, there is a serious increase in type 2 diabetics, particularly among the young. 

Which of the following occurs with insulin-dependent, juvenile-onset, type 1 diabetes ... 

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