Cognitive dysfunction in diabetes - the 'forgotten' diabetes complication: a narrative review.

Background: In addition to peripheral neuropathy of various kinds, diabetes can also cause central neuropathy, which among other things can manifest itself as premature cognitive dysfunction, often linked to vascular dysfunction. Although the link between diabetes and cognitive dysfunction was discovered more than 100 years ago and has important clinical implications, this diabetes complication remains relatively unknown. Recent years have seen research that has clarified cerebral insulin resistance and defective insulin signaling as examples of pathogenic factors behind this cognitive impairment in diabetes.

[Glucokinase activators and imeglimin: New drugs against type 2 diabetes].

Type 2 diabetes (T2D) is increasing relentlessly globally, affecting ever younger patients. Many T2D patients do not attain glycemic target levels, indicating a clear need for novel antihyperglycemic drugs. Ideally, these should not only control glycemia, but also halt or slow the progressive loss of beta cells.

A Rare Case of Testosterone-Producing Non-Seminoma Germ-Cell Testicular Cancer.

Androgen secretion by testicular germ-cell tumors (GCTs) appears to be markedly rare and likely underreported in the literature. This case study highlights a patient with such a rare tumor, underscoring a notable and yet easily avoidable diagnostic oversight in one of the most prevalent cancers among men. We advocate for increased vigilance and the inclusion of specific symptomatic screening for hyperandrogenism of select patients in existing guidelines and, where appropriate, the implementation of standardized hormonal laboratory analyses in both pre- and post-orchidectomy assessments.

Ephemeral Diabetes After COVID-19 Vaccination.

We report a case of new-onset, nonautoimmune, nonketotic, and noninsulinopenic type 2-like diabetes in a previously normoglycemic middle-aged man debuting after vaccination against COVID-19. This was not a mild or short-lived glucose intolerance, but severe and long-standing hyperglycemia with a high glycated hemoglobin level. However, the course of the diabetes was highly atypical and surprising in that it spontaneously disappeared after a few months and did not recur despite the patient being off all antidiabetic drugs for several months and without any changes in body weight or lifestyle.

[Glycogenic hepatopathy/hepatic glycogenosis: an underappreciated but benign and reversible diabetic complication].

Almost 100 years ago, the French physician Pierre Mauriac described a syndrome named after him, resulting from poorly controlled type 1 diabetes, with growth retardation, delayed puberty, Cushingoid features and hepatomegaly. With modern diabetes care, this is very rare but does occur; however, despite the condition having important clinical implications and being easily treatable, this diabetes complication remains relatively unknown. We present here an authentic patient case in the form of a young man with glycemically poorly controlled type 1 diabetes who developed hepatomegaly, hyperlactatemia and histopathological changes in the liver consistent with glycogenosis, a state readily reversed by normalization of glycemia.

Glucokinase activators and imeglimin: new weaponry in the armamentarium against type 2 diabetes.

The prevalence of type 2 diabetes (T2D) is increasing relentlessly all over the world, in parallel with a similar increase in obesity, and is striking ever younger patients. Only a minority of patients with T2D attain glycemic targets, indicating a clear need for novel antidiabetic drugs that not only control glycemia but also halt or slow the progressive loss of β-cells. Two entirely novel classes of antidiabetic agents-glucokinase activators and imeglimin-have recently been approved and will be the subject of this review.

[Diabetes and cognitive decline - An often overlooked association].

In addition to peripheral neuropathy of various manifestations, diabetes is also associated with central neuropathy. This can manifest as premature cognitive decline, although the role of hyperglycemia in this process remains ambiguous. Notwithstanding that the link between diabetes and cognitive decline was discovered 100 years ago, and has important clinical implications, this co-morbidity remains relatively unknown.

GAD-65 antibodies in a case of HNF1A-Maturity-Onset Diabetes of the Young: Double diabetes?

Diabetes classification is not as defined as it used to be. A patient with one type of diabetes can have diagnostic criteria of another type, which may affect the course of the disease. Clinicians need to consider that when dealing with patients who do not fit the exact description of their diagnosed type of diabetes.

Hemiballismus in hyperglycemia.

Diabetes may cause late complications in the CNS but certain lesions may also occur acutely in hyperglycemia. We describe a case of hyperosmolar non-ketotic syndrome and reversible hemichoreic dyskinesia with morphological changes in basal ganglia.

[Type B insulin resistance syndrome].

Type B insulin resistance syndrome (TBIRS) is a very rare autoimmune condition with polyclonal autoantibodies directed against the insulin receptor, which results in severe and refractory hyperglycemia and high mortality. Described here is a patient who, within a few months after the onset of an autoimmune type 1 diabetes, increased her insulin requirements more than 20-fold, and despite this having a considerable difficulty maintaining  her P-glucose < 40-60 mmol/L. On suspicion of TBIRS the patient was started on tapering glucocorticoids to overcome the autoimmune insulin receptor blockade, resulting in an immediate and dramatic effect.

Atypical diabetes: a diagnostic challenge.

In medical school, we learned how to classify diabetes according to different clinical characteristics. However, at the dawn of the precision medicine era, it is clear that today's clinical reality does not always align well with textbook teachings. The terms juvenile versus elderly-onset diabetes, as well as insulin-dependent versus non-insulin-dependent diabetes, have become obsolete.

Type B insulin resistance syndrome in a patient with type 1 diabetes.

Summary: Type B insulin resistance syndrome (TBIRS) is a very rare autoimmune disorder with polyclonal autoantibodies against the insulin receptor, resulting in severe and refractory hyperglycemia. Described here is a patient who within a few months after the onset of autoimmune type 1 diabetes increased her insulin requirements more than 20-fold; despite this she had considerable difficulty maintaining a plasma glucose value of <40-60 mmol/L (720-1100 mg/dL). On suspicion of TBIRS, the patient was started on tapering dose of glucocorticoids to overcome the autoimmune insulin receptor blockade, resulting in an immediate and pronounced effect.

[Double diabetes - a metabolic challenge].

In Northern Europe, we are used to classifying diabetes as either type 1 or type 2 (with some exceptions). These exceptions include secondary diabetes (e.g.

Prediabetic Dysglycemia: Call for Action.

Different dysglycemic states precede overt type 2 diabetes. Prediabetic dysglycemia also carries an increased cardiovascular risk per se. Prediabetic dysglycemia may be divided into impaired fasting glycemia, impaired glucose tolerance and intermediate hyperglycemia.

Ketosis-Prone Type 2 Diabetes: A Case Series.

Ketosis-prone type 2 diabetes ("Flatbush diabetes") carries features of both classical type 1 and type 2 diabetes and is highly prevalent in African populations. The disease, which is highly ketosis-prone, but neither chronically insulinopenic nor autoimmune, is discussed regarding pathogenesis, diagnosis and treatment from a patient case perspective.

[Possible to prevent prediabetes from progressing to manifest type 2 diabetes].

Different prediabetic states precede overt type 2 diabetes. Prediabetes also carries an increased cardiovascular risk per seand may be divided into fasting hyperglycemia, impaired glucose tolerance and intermediate hyperglycemia. Mixed forms of these are very common.

[A survey of various adjuvant treatments used against type 1 diabetes, focusing on SGLT2 inhibitors].

Insulin and its analogues have so far and for almost 100 years been the only officially approved treatment for type 1 diabetes in Europe. However, in clinical practice, various drugs against type 2 diabetes have sometimes been used off label as adjuvants to insulin for type 1 diabetes. Recently, the EMA approved the SGLT2 inhibitor dapagliflozin as an adjuvant treatment for type 1 diabetes in adults.