22.7 DIABETES MELLITU

• TABLE 22.15: Causes of delayed puberty

•

• Constitutional

• Hypogonadotropic hypogonadism

• Primary hypopituitarism

- CNS infections, trauma, radiation, tumors

- Genetic: Isolated GH or gonadotropin deficiency

• Secondary hypothalamic/pituitary suppression

- Hyperprolactinemia

• Hypothyroidism

• Chronic infections, malnutrition, systemic disease

• Others: Laurence-Moon-Biedl syndrome

Hypergonadotropic hypogonadism

• Congenital gonadal dysgenesis

• Chromosomal: KlinefelterzTurner syndrome

• Disorders of steroid biosynthesis

• Acquired gonadal injury

- Infection: Orchitis (mumps)

- Iatrogenic: Surgery, radiation, chemotherapy

- Trauma/torsion of testis

Diabetes mellitus (DM) is the commonest endocrine metabolic disorder of childhood, characterized by hyperglycemia due to deficiency of insulin or its action, with abnormal carbohydrate metabolism, and to some extent, the fat and protein metabolism.

According to the etiopathogensis, DM is classified as:

• Type I or insulin dependent (T1DM), due to severe insulin deficiency, which is common in children.

• Type II or non-insulin dependent (T2DM) due to insulin resistance, with/ out insulinopenia, which is common in adults,

• Secondary diabetes due to drugs, e.g. steroids, genetic disorders of beta cell function (maturity onset diabetes of young or MODY), pancreatic disorders, intrauterine infections and other endocrinopathies, e.g. Cushing disease.

In addition, many children or adults have impaired glucose tolerance without definite evidence of DM, specially during stress, e.g. pregnancy, infections or after high-carbohydrate meals, which can be considered as a risk-factor for future DM.

22.7.1