• Gestational diabetes
Type 1 diabetes
• Previously known as IDDM(Insulin dependent diabetes) • Ketosis prone:Usually diagnosed in younger age group(<30 years) (Peak incidence 11-13 yr) • Prevalence highly variable but approximately 0.20% with an incidence of 15-20 per 100000 population aged less than 21 • Seasonal variation- with lowest rate in spring and summer
• Type 2 (may range from
predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with or without insulin resistance)
The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both
• Genetics • Environmental factor Viruses Chemical agents • Autoimmune Auto-antibodies: islet cell cytoplasm antibody (ICCA) islet cell surface antibody (ICSA) glutamic acid decarboxylase antibody GADA(64KD) Insulin antibody (IAA)
• Type 1 (beta–cell destruction,
usually leading to absolute insulin deficiency) : Autoimmune: Idiopathic
• Other specific types
Genetic defects of beta–cell function • • • • • • Genetic defects in insulin action Diseases of the exocrine pancreas Endocrinopathies Drug– or chemical–induced Infections Uncommon forms of immune– mediated diabetes Other genetic syndromes sometimes associated with diabetes
Type 1 diabetes
• This presentation is the end point of recent and continuing beta cell function resulting in near total loss of Insulin production • Hypபைடு நூலகம்rglycaemia itself begets further beta cell destruction as treatment with insulin often results in a “honeymoon” period when the patient can often manage without insulin
Diabetes Mellitus
Diabetes Mellitus
• • • • • • • definition types symptoms diagnosis Laboratory findings treatment complications
Definition-WHO (4/2000)
Diabetes Mellitus
• • • • • • • definition types symptoms diagnosis Laboratory findings treatment complications
Aetiological Classification of Disorders of Glycaemia
Type 1 diabetes mellitus
• Immune-mediated type 1 diabetes acute LADA latent autoimmune diabetes in adults • Idiopathic type 1 diabetes mellitus
Type 1 diabetes mellitus
Definition
• A metabolic condition characterised by high plasma glucose levels and chronic vascular complications • A vascular disease affecting small and large arteries with coexistent metabolic disturbance particularly high plasma glucose levels