Diabetes mellitus

Potent endogenous insulin diabetes mellitus (DM) is a disease caused by a lack or reduction. It is characterized by hyperglycemia, metabolic and vascular sequelae crazy important impact. The major types of diabetes:

Type 1 diabetes: results from the body's inability to produce enough insulin.
Type 2 diabetes results from insulin resistance, often initially with normal or elevated circulating levels of insulin.
Gestational diabetes: who have never had diabetes, blood sugar (glucose) levels during pregnancy pregnant women with gestational diabetes. Gestational diabetes affects about 4% of pregnant women. Type 2 diabetes (or rarely 1), can be developed first.
Maturity-onset diabetes of the young (MODY) various forms, including single-gene defects of β-cell function (impaired insulin secretion), usually at an early age manifested as mild hyperglycemia, diabetes, genetic autosomal dominant mode of inheritance. 1]
Secondary Diabetes: represents only 1-2% of patients with diabetes. Reasons include:
Pancreatic disease cystic fibrosis, chronic pancreatitis, pancreatic cancer, pancreatic cancer.
Endocrine: acromegaly, Cushing syndrome, thyroid function hyperthyroidism, pheochromocytoma, glucagon.
Caused by drugs: thiazide diuretics, corticosteroids, atypical antipsychotics, antiretroviral protease inhibitors.
Congenital disorders of fat metabolism.
Acanthosis nigricans.
Genetics: Wolfram syndrome (also known as "DIDMOAD: diabetes insipidus, diabetes mellitus, optic atrophy, deafness), [2] Friedreich's ataxia, myotonic dystrophy, hemochromatosis, glycogen storage disease.
Some patients with type 2 diabetes need insulin, type 1 diabetes and non-insulin dependent diabetes mellitus (NIDDM), type 2 diabetic patients with insulin-dependent diabetes mellitus (IDDM) old terms inappropriate. The diagnosis of type 2 diabetes is a growing number of children and young and old maturity-onset diabetes any, type 2 diabetes is also inappropriate.


Diabetes mellitus type 1

These are usually juvenile diabetes - about 15%, but can occur at any age. It may be associated with other autoimmune diseases. It is characterized by a lack of insulin.
The same word is> 30% in monozygotic twins, the four gene was considered important. A (6Q), determines the sensibility islets damage - for example, virus, or antibody-induced cross-reactive milk.
Related HLA DR3, DR4 and the time of islet cell antibody diagnostic around. Patients require insulin treatment, is prone to ketoacidosis.
Approximately the same risk of developing type 1 diabetes, people of all ethnic groups in the country, but there is increasing evidence that genetic susceptibility of the individual in early childhood development of autoimmune islet β-cells, which caused certain pathogens or components of the diet.
The term "diabetes 1a 'is applied to the development of type 1 diabetes results from an autoimmune T cell mediated destruction of islet cells.


Type 2 diabetes mellitus

Approximately 85% of patients with diabetes, often present (usually> 30 years), but its diagnosis more and more children and adolescents. [4]
Type 2 diabetes and excess weight and physical activity.
The impact of all ethnic groups, but in South Asia, Africa, the increased prevalence of the ancestors of the peoples of Africa - Caribbean, Polynesia, India, Middle East and United States.
Caused by impaired insulin secretion and insulin resistance, there is a gradual onset.
Patients with type 2 diabetes may eventually need insulin treatment.

Prevalence

In 2011, 290 million people suffer from diabetes. It is estimated that by 2025, 500 million people with diabetes in the UK.
An estimated 85 million people with diabetes in the UK, but have not been diagnosed.
UK average prevalence of diabetes in the UK is 4.45%, but there are also differences between countries and regions.
Diabetic patients with increasing age, the proportion of the population.
However, the incidence of diabetes is increasing in all age groups. Increase in children with type 1 diabetes (age <5 years), more and more patients with type 2 diabetes, especially in groups of black and ethnic minorities.

Risk factors for type 2 diabetes
Obesity, especially central obesity (trunk).
Lack of physical activity.
Race: People, South Asia, Africa, Africa - Caribbean, Polynesia, the Middle East and American Indian descent are at increased risk of type 2 diabetes, compared to whites.
History of gestational diabetes.
Glucose intolerance.
Impaired fasting glucose.
Medications, such as the joint use of thiazide diuretics, beta-blockers.
Low-fiber, high-glycemic index diet.
The metabolic syndrome.
Polycystic ovary syndrome.
Family history (2.4 times the risk of type 2 diabetes).
Adults with low birth weight, gestational age.

Introduction

Polyuria, polydipsia, lethargy can occur with all types of diabetes, boils, genital itching or use common infection, recurrent or persistent.
Patients with type 1 diabetes, may be weight loss, dehydration, ketonuria and hyperventilation. Demonstration of type 1 diabetes is often a very short time of acute symptoms.
Presentation in patients with type 2 diabetes often subacute symptoms persist for a long time.
Diabetes can occur in patients with acute or chronic complications, outlining "a complication, as follows.

Diagnosis

The diagnosis of diabetes can be an exception based on random blood glucose (≥ 11.1 mmol / L or glucose ≥ 7 mmol / L) are, for example: thirst, increased urination, recurrent infections, weight loss, lethargy and coma symptoms of diabetes.
In alterations random blood glucose in asymptomatic persons, two fasting venous anomalies within samples of blood glucose (≥ 7 mmol / L's) recommendations for diagnosis.
The two hour plasma glucose concentration ≥ venous 11.1 mmol / L, 75 g of anhydrous glucose two hours following the OGTT glucose tolerance (OGTT).
World Health Organization (WHO) recommends that glycated hemoglobin (HbA1c) can be used as a diagnostic test for diabetes. 48 mmol / mol (6.5%) suggests that the diagnostic cutoff for diabetes of glycated hemoglobin. Value of less than 48 mmol / mol, not exclude the use of diagnostic testing of blood glucose in diabetes.