Secondary diabetes due to different etiologies: Four case reports

Abstract

BACKGROUND

As research on diabetes continues to advance, more complex classifications of this disease have emerged, revealing the existence of special types of diabetes, and many of these patients are prone to misdiagnosis and underdiagnosis, leading to treatment delays and increased health care costs. The purpose of this study was to identify four causes of secondary diabetes.

CASE SUMMARY

Secondary diabetes can be caused by various factors, some of which are often overlooked. These factors include genetic defects, autoimmune disorders, and diabetes induced by tumours. This paper describes four types of secondary diabetes caused by Williams–Beuren syndrome, Prader–Willi syndrome, pituitary adenoma, and IgG4-related diseases. These cases deviate significantly from the typical progression of the disease due to their low incidence and rarity, often leading to their neglect in clinical practice. In comparison to regular diabetes patients, the four individuals described here exhibited distinct characteristics. Standard hypoglycaemic treatments failed to effectively control the disease. Subsequently, a series of examinations and follow-up history confirmed the diagnosis and underlying cause of diabetes. Upon addressing the primary condition, such as excising a pituitary adenoma, providing glucocorticoid supplementation, and implementing symptomatic treatments, all patients experienced a considerable decrease in blood glucose levels, which were subsequently maintained within a stable range. Furthermore, other accompanying symptoms improved.

CONCLUSION

Rare diseases causing secondary diabetes are often not considered in the diagnosis of diabetes. Therefore, it is crucial to conduct genetic tests, antibody detection and other appropriate diagnostic measures when necessary to facilitate early diagnosis and intervention through proactive and efficient management of the underlying condition, ultimately improving patient outcomes.

Keywords: Secondary diabetes; IgG4-associated diseases; Williams–Beuren syndrome; Pituitary adenoma; Prader–Willi syndrome; Genetic defects; Case report

Core Tip: The etiology of secondary diabetes is complex, and it is often misdiagnosed as common type 2 diabetes in clinic, especially diabetes caused by some rare diseases, including Williams-Beuren syndrome, Prader-Willi syndrome, Pituitary adenoma, and IgG4-related diseases. It is difficult to confirm before some special tests, such as genetic testing, these posing a challenge for physicians. The aim of this report is to summarize the diagnosis and treatment of these four secondary diabetes patients, and to provide perspective and reference to other relevant cases.