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Diabetes Mellitus: Types!

TYPES OF DIABETES MELLITUS

1. TYPE1 DM

  • Type 1 DM is usually diagnosed before age 30 years, but it can develop at any age.
  • T1DM is an autoimmune disease in which insulin producing B-cells are destroyed.
  • The presence of Human Leucocyte Antigens (HLAs) is associated with the development of T1DM.
  • In addition, these individuals often develop Islet cell antibodies, Insulin Autoantibodies or Glutamic Acid decarboxylase autoantibodies.
  • At the time of development of diagnosis of T1DM, it is usually believed that most of the patients have 80-90%loss of beta cells.
  • The remaining beta cells function at the diagnosis creates a " HONEYMOON PERIOD" during which the blood glucose levels are easier to control, and smaller amounts of insulin are required. after this, the remaining beta cells function is completely lost, and the patients become completely deficient of insulin and hence require exogenous insulin. 




2. TYPE1.5 DM: 

  • Also referred as Latent autoimmune diabetes in Adults (LAD) or SLOW ONSET5 TYPE 1 or TYPE 1.5 DM.
  • It is a form of autoimmune T1DM that occurs in individuals older than the usual age of T1DM.
  • Patients are often mistakenly thought to have T2DM because of the old age of person and he may also respond to the initial treatment with oral-blood glucose lowering agents.
  • These patients do not possess insulin resistance but there are antibodies present that destroy the pancreatic beta cells.


3. T2 DM:

  • It is usually slower and progressive. 
  • Risk factors include:

  1. Obesity
  2. First degree family history
  3. Race or ethnicity
  4. Habitual physical inactivity
  5. Hypertension
  6. Previously identified IFG, IGT, or Ac1 between 5.7%-6.4%
  7. High density lipoproteins: HDL less than 5mg/dL, Triglycerides level >250mg/dL
  8. Cardiovascular disease history
  9. Polycystic ovarian syndrome history


4. GDM:

  • Gestational DM is defined as glucose intolerance in women during pregnancy.
  • This complication develops between 2%-10% of pregnancies.
  • Women who have GDM have 35%-60% chances of developing T2DM.
  • All pregnant women who do not have previously identified diabetes are asked to undergo screening between 24 and 28 weeks of gestation.

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