diabetes mellitus (definition, classification, clinical features)

DIABETES MELLITUSDefinition, Classification, Risk factors &

Clinical Features

MARYAM JAMILAH BINTI ABDUL HAMID082013100002

IMS BANGALORE

LEARNING OUTCOME

• Definition

• Classification

• Risk factors

• Clinical features

DEFINITION

Metabolic diseases characterized by

hyperglycemia resulting from defects in insulin

secretion, insulin action, or both

CLASSIFICATION

DIABETES MELLITUS

Type 1 diabetes

Type 2 diabetes

Other specific types of diabetes

Gestational diabetes

mellitus (GDM)

TYPE 1 DIABETES

• Also known as Juvenile Onset Diabetes

• Complete or near-total insulin deficiency

• Occurs <14 years old of age

• Underweight patient

• Genetic factor

– Uncommon

– Develop antibodies against β–cells of islet

• Develop ketosis; if untreated

• Insulin secretion

Low/absent due to –cell pathology

(autoimmune disease)

• Sensitive to insulin

Type 1 diabetes (continuation)

• Most common

• >40 years of age

• Normal or overweight

• Genetic factor

– Strongly positive

TYPE 2 DIABETES

• Ketosis with infection (often absent)

• Insulin secretion

Initially normal or but later

β-cells are usually normal but disturbance is

*less active insulin production

*less cellular response to insulin due to

deficiency of GLUT 4 in insulin sensitive cells

*presence of antibodies against insulin

• Insulin resistant

Genetic defects of β cell function characterized by mutation

Genetic defects in insulin actionDisease of exocrine pancreasEndocrinopathiesDrug-or chemical-induced InfectionsUncommon forms of immune-mediated diabetesOther genetic syndromes associated with

diabetes

OTHER SPECIFIC TYPES OF DIABETES

• In pregnancy (glucose intolerance)

• Insulin resistance

– metabolic changes of late pregnancy

• Most women revert to normal glucose

tolerance post-partum but have substantial

risk (30-60%) of developing diabetes mellitus

later in life

GESTATIONAL DIABETES MELLITUS (GDM)

RISK FACTORS

Predisposing factors

Hereditary

Age (increasing age)

Obesity

BMI

Adipose tissues in obese people are more resistant to

insulin

Lifestyle

high fat and cholesterol levels

Smoking

Sedentary lifestyle

CLINICAL FEATURES

• Hyperglycemia

• Glycosuria

• Polyuria

• Polydipsia

• Polyphagia

• Dehydration

• Loss of weight

• Poor resistance to

infections due to

protein depletion

REFERENCES

• AK JAIN, Volume II, 3rd edition• Harrison’s Internal Medicine, Volume II, 17th

edition• http://care.diabetesjournals.org/content/27/

suppl_1/s5.full