Diabetes mellitus: types, diagnosis and etiology

DIABETES MELLITUS

A group of common metabolic disorders that share the phenotupe of hyperglycemia.

Classification

DM 1

Is the result of interactions of genetic, environmental, and immunologic factors thar ultimately lead to the destruction of the pancreatic beta cells and insulin deficiency.

DM 2

Insulin resistance and abnormal insulin secretion are central to the development of type 2 DM. Insulin resistance precedes an

insulin secretory defect but that diabetes develops only when insulin secretion becomes inadequate

Gestational

Insulin resistance is related to the metabolic changes of late pregnancy, and the increased insulin requierements, Occurs in 2-10% of pregnancies.

Etiologic

Type 1: beta cell destruction, usually leading to absolute insulin deficiency

A. Immune-mediated

B. Idiopathic

Type 2: may range from predominantly insulin resistance with relative insulin deficiency to a predominantly insulin secretory defect with insulin resistance

Other: Infections, Genetic defects, Pancreatitis, Cushing's syndrome

Epidemiology

The worldwide prevalence of DM has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 285 million in 2010. Based on current trends, the International Diabetes Federation projects that 438 million individuals will have diabetes by the year 2030

Diagnosis

• Symptoms of diabetes plus random blood glucose concentration

≥11.1 mmol/L (200 mg/dL) or

• Fasting plasma glucose ≥7.0 mmol/L (126 mg/dL) or

• A1C > 6.5%c or

• Two-hour plasma glucose ≥11.1 mmol/L (200 mg/dL) during an

oral glucose tolerance test

GISSELL DANAHÉ GUTIÉRREZ PADILLA