Definition, epidemiology, diagnosis and classification

Other specific types

Longer survival of cystic fibrosis (CF) patients results in 10–30% of 15- to 25-year-olds developing diabetes
Screening for hyperglycemia, glycosuria and/or HbA_1c is recommended as part of the annual review of CF patients and particularly if steroid treatment is used
Insulin treatment will improve hyperglycemia and help to prevent catabolic weight loss in CF especially during intercurrent infections
High dietary energy intake is recommended including high fat and high complex carbohydrate

Iron overload affecting beta-cell function and the decreasing insulin sensitivity of puberty are thought to contribute to the risk of diabetes in young people with thalassemia
Some studies suggest that treatment with high doses of insulin is required if iron levels remain high

Atypical diabetes in young people occurs in some developing countries
Previously named malnutrition-related diabetes mellitus (MRDM), it may be characterized by lean body mass, relative ketosis resistance and superimposed nutritional deficiencies
There may be calcification of the pancreas, or protein deficiency pancreatic diabetes
The ketosis ‘resistance’ may reflect later onset, less severe type 1 diabetes in children who survive long enough to reach medical attention

Insulin-dependent diabetes mellitus usually presenting in the first decade
Insidious onset of diabetes insipidus, deafness and visual impairment
Non-autoimmune genetic condition, usually autosomal recessive
Potentially progressive deterioration in neurological function with cerebral atrophy and psychological disturbances in the third or fourth decade
Gene localized to chromosome 4p

Severe obesity is associated with a high incidence of secondary diabetes in the second decade
Weight reduction is extremely difficult
The diabetes is type 2, usually responding poorly to oral hypoglycemic agents; most patients require insulin