Types of diabetes

Diabetes mellitus is a complex, metabolic disorder, which may clinically categorize in one of five different classifications. The major classifications are non-insulin dependent diabetes mellitus (NIDDM) and insulin-dependent diabetes mellitus (IDDM).

Characteristic of Type I and Type II Diabetes Mellitus

Characteristics	Insulin Dependent (IDDM) Type I	Non Insulin Dependent (NIDDM) Type II
Insulin Status	Insulin secretion is decreased	Insulin secretion is increased, decreased, or normal
Age	Usually in young but may occur at any age	Usually over 40 but may occur at any age
Onset	Rapid	Slow
Body Build	Lean	80%-90% overweight
Family History	Questionable	Strong
Islet Cell Antibodies	Present at onset	Absent
Incidence	10 percent of total	90 percent of total
Symptoms	Polyuria, polydipsia, polyphagia, weight loss	None, or the same as type I, especially if stressed
Ketones	Prone	Resistant except during infection or with stressors
Complications- vascular/neurologic	After 5 or more years	Frequent (may be present at diagnosis)
Treatment	Insulin, diet, exercise	Diet, exercise, oral agents, insulin
Racial Distribution	More common in white	More common in African-Americans and Hispanics; highest in Native Americans
Environmental Factors	Frequent coincidence between IDDM and viral infections	Modern lifestyle of poor eating habits (resulting in obesity) and inactivity provides stimulus for those who are genetically predisposed.

Other Categories of Diabetes Mellitus and Glucose Mellitus 

• Juvenile type – has a rapid onset and requires insulin administration, whereas adult onset type has a gradual onset and sometimes may be controlled by diet

• Gestational Diabetes Mellitus (GDM) - persons have onset of glucose abnormality during pregnancy.

Women with know diabetes mellitus who become pregnant are not classified in this group.

After delivery, the woman is reclassified on the basis of blood or plasma glucose testing.

Malnutrition- related diabetes mellitus – Person require insulin. Diabetes mellitus found in tropical areas. It occurs in young adults with histories of nutritional deficiencies. Ketosis is usually not present.

Other types of diabetes mellitus – Diabetes mellitus associated with other disorders such as pancreatic disease, other endocrine diseases, drugs, and genetic syndromes. Person usually requires insulin.

Impaired Glucose Tolerance – Persons have glucose level higher than normal but lower than those considered diagnostic for diabetes mellitus.

Persons may be sub classified as obese or nonobese, or be included with persons with other conditions such as pancreatic disease, other endocrinopathies, or drug history.

Previously Abnormality of Glucose Intolerance (PreAGT)

• persons have hostiry of glucose intolerance but now have normal glucose levels

• it is designed for epidemiologic and research purpose

Potential Abnormality of Glucose (PotAGT)

• persons have no history of glucose intolerance but have a potentially higher risk because of historical factors such as delivering babies, obesity, or relatives with diabetes mellitus

 Classic Signs of Diabetes Mellitus

• Polyuria- excessive urination

• Polydipsia- excessive thirst

• Polyphagia – extreme hunger and increased food intake

 * Nearly always present in IDDM and can be present in NIDDM. However, many persons with NIDDM have very subtle symptoms of acute metabolic changes or chronic complications, such as extreme fatigue, blurring of vision, and falling asleep in the chair.