Types of diabetes mellitus

1-insulin-dependent diabetes ( IDDM), type 1 diabetes:

  A severe, chronic form of diabetes caused by insufficient production of insulin and resulting in abnormal metabolism of carbohydrates, fats, and proteins. The disease, which typically appears in childhood or adolescence, is characterized by increased sugar levels in the blood and urine, excessive thirst, frequent urination, acidosis, and wasting. An autoimmune response is believed to be triggered by a virus or another microorganism that destroys the cells that produce insulin..

2- Non- insulin dependant diabetes mellitus(NIDDM))(Type II):

   It is the more common form of diabetes, occurs in approximately 3–5% of age under 50 years of age, and increases to 10–15% in those over 50. More than 90% of the diabetics in the United States are Type II diabetics. Sometimes called age-onset or adult-onset diabetes, this form of diabetes occurs most often in people who are  overweight and who do not exercised.

Etiology of Type 2 Diabetes

•Response to insulin is decreased-↓glucose uptake by the muscle and ↑glucose production (liver)

•The mechanism of insulin resistance is unclear

•Both genetic & environmental factors are involved

Manifestations of both type 1 and type 2 diabetes include:

Excessive thirst (polydepsia), increased appetite (polyphagia), increased urination (polyuria), weight loss, fatigue, nausea, blurred vision, frequent vaginal infections in women, impotence in men, frequent fungal infections, lowered resistance to infection and delay in healing after periodontal therapy, hyperglycemia, glycosuria, polyuria, hyperlipemia (caused by imperfect catabolism of fats), ketonuria and acidosis. When there is not enough insulin produced or when the doorway no longer recognizes the insulin key, glucose stays in the blood instead of entering the cells.

The body will attempt to dilute the high level of glucose in the blood, a condition called hyperglycemia, by drawing water out of the cells and into the bloodstream. The excess sugar is excreted in the urine. It is not unusual for people with undiagnosed diabetes to be constantly thirsty, to drink large quantities of water, and to urinate frequently as their bodies try to get rid of the extra glucose. This creates high levels of glucose in the urine.

At the same time that the body is trying to get rid of glucose from the blood, the cells are starving for glucose and sending signals to the body to eat more food, thus making patients extremely hungry. To provide energy for the starving cells, the body also tries to convert fats and proteins to glucose. The breakdown of fats and proteins for energy causes acid compounds called ketones to form in the blood. Ketones also will be excreted in the urine. As ketones build up in the blood, a condition called ketoacidosis can occur. If left untreated, ketoacidosis can lead to coma and death

Ketoacidosis, a condition due to starvation or un-controlled diabetes, is common in Type I diabetes. Ketones are acid compounds that form in the blood when the body breaks down fats and proteins. Symptoms include abdominal pain, vomiting, rapid breathing, extreme tiredness, and drowsiness. Patients with ketoacidosis will also have a sweet breath odor. Left untreated, this condition can lead to coma and death.