Background Mucormycosis has been reported in several Indian states with the second wave of COVID-19 from January 2021 onwards. This prospective study was conducted with the objective of defining the contribution or association of various known and many suspected factors in the incidence of this disease during the ongoing pandemic.
Mutations in the HNF4A gene are associated with hyperinsulinaemic hypoglycaemia in infants, frequently evolving into relative deficiency of insulin in adulthood as maturity onset diabetes of the young (MODY). A 69-year-old male with a strong family history of adult-onset diabetes was referred with lifelong hypoglycaemia, found to be due to a pathogenic HNF4A mutation. HbA1c levels were low, continuous glucose monitoring demonstrated frequent low glucose events in the early morning, and he was successfully treated with diazoxide.
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Alström syndrome is a rare ciliopathy affecting about 1 in 1,000,000 individuals. It is characterised by cone-rod dystrophy, insulin resistance, diabetes mellitus, cardiomyopathy, renal failure and hypogonadism. Progressive multi-organ dysfunction eventually leads to death. Only about 800 patients with this disorder have been identified so far. The diagnosis of Alström syndrome is critical as it can easily be overlooked because of the many features it shares with metabolic syndrome.
The diagnosis of diabetes subtypes in a busy clinic is usually based on the age at onset, phenotype and biochemical diagnostic criteria. Not surprisingly, the focus is predominantly on diagnosing type 1 and type 2 diabetes. More challenging for the physician is to think of monogenic diabetes, which results from gene mutations that reduce beta cell function. Often misdiagnosed as type 1 or type 2 diabetes, maturity-onset diabetes of the young (MODY) is the most common form of monogenic diabetes, accounting for 1–2% of all diabetes cases.
John JR Macleod (1876–1935,) an Aberdonian Scot who had emigrated
to North America, shared the 1923 Nobel Prize with Frederick Banting for their
discovery of insulin at the University of Toronto in 1921–22. Macleod finished his
career as Regius Professor of Physiology at the University of Aberdeen from 1928
to 1935. Macleod’s posthumous reputation was deeply tarnished by the campaigns
against him carried out by his fellow laureate, Banting, and by Banting’s student
assistant during the insulin research, Charles Best. Banting’s denigration of Macleod
Keywords Diabetes, insulin, health services
Declaration of Interests No conflicts of interest declared.
An ever-increasing number of women with Type 2 diabetes mellitus (DM) are going through pregnancy and, with the current epidemic of obesity, more women are being diagnosed with gestational diabetes mellitus (GDM). Insulin has traditionally been the gold standard in diabetic pregnancy because of its efficacy and the fact that it does not cross the placenta. However, recent data from welldesigned trials and meta-analysis on the use of oral agents in gestational diabetes may mark a significant shift in clinical practice.
