Classification of Diabetes Mellitus

WHO Definition of Diabetes Mellitus

A state of chronic hyperglycaemia which may result from genetic or environmental factors often acting jointly. Hyperglycaemia may be due to a lack of insulin or an excess of one or more factors that oppose the action of insulin.

Classification

Primary

1. Type 1: Insulin dependent diabetes mellitus (IDDM) – severe, labile, occurs usually at younger age but can occur at any age, liable to develop ketoacidosis.
2. Type 2: Non-insulin dependent diabetes mellitus (NIDDM) – not prone to ketoacidosis, patients are often obese, and is of maturity onset.

Secondary

1. Pancreatic disorders:

–       Chronic pancreatitis

–       Pancreatectomy/trauma

–       Neoplasia

–       Cystic fibrosis

–       Hemachromatosis

–       Fibrocalculous pancreatopathy

–       Chronic pancreatitis

2. Endocrine disorders :

–       Acromegaly

–       Cushing syndrome

–       Hyperthyroidism

–       pheochromocytoma.

–       glucagonoma.

3. Genetic disorders:

–       hemochromatosis,

–        syndrome X (metabolic syndrome),

–        maturity onset diabetes of die young (MODY)

4. Drug induced:

–       Glucocorticoids

–       Thyroid hormone

–       Interferon-α

–       Protease inhibitors

–       β-adrenergic agonists

–       Thiazides

–       Nicotinic acid

–       Phenytoin (Dilantin)

5. Infections:

–        Mumps

–       Congenital rubella,

–       Cytomegalovirus (AIDS patients)

Gestational

Glucose intolerance that develops during pregnancy.

Comparison between Type I and Type II Diabetes Mellitus

                                                  TYPE-1                                           TYPE-2

 

Age:                               < 40 Years                                     >40years            

Duration:                          Weeks                                   Months To Years

Ketonuria:                       Common                                           Rare

Insulin- Dependent          Yes                                                    No

Autoantibody:                  Yes                                                    No

Family History:                 No                                                    Yes

Insulin Levels:               Very Low                                  Normal To High

Islets:                             Insulinitis                                  Normal/Exaustion

Complications:        Acute & Metabolic                         Late And Vascular

                                                Ketoacidosis                                 Microangiopathies