Sunday, March 15, 2015
Classification of Diabetes Mellitus
Type 1 diabetes (β-cell destruction): Immune-mediated, Idiopathic
Type 2 diabetes (insulin resistance with relative insulin deficiency)
Maturity-onset diabetes of the young (MODY), caused by mutations in:
Hepatocyte nuclear factor (MODY1)
Glucokinase (MODY2)
Genetic defects in insulin processing or insulin action
Defects in proinsulin conversion
Insulin gene mutations
Insulin receptor mutations
Exocrine pancreatic defects
Chronic pancreatitis
Pancreatectomy
Neoplasia
Cystic fibrosis
Hemachromatosis
Endocrinopathies
Acromegaly
Cushing syndrome
Hyperthyroidism
Pheochromocytoma
Glucagonoma
Infections
Cytomegalovirus
Coxsackie virus B
Drugs: Glucocorticoids, Thyroid hormone, Protease inhibitors, b-adrenergic agonists, Thiazides, Nicotinic acid, Phenytoin
Genetic syndromes associated with diabetes
Down syndrome
Kleinfelter syndrome
Turner syndrome
Gestational diabetes mellitus.
Dx of DM:(diagnosis of Diabetes Mellitus)
A random blood glucose concentration of 200 mg/dL or higher, with classical signs and symptoms
A fasting glucose concentration of 126 mg/dL or higher on more than one occasion, or
An abnormal oral glucose tolerance test (OGTT), in which the glucose concentration is 200 mg/dL or higher 2 hours after a standard carbohydrate load (75 gm of glucose.
Pt with impaired glucose tolerance have a significant risk of progressing to overt diabetes.
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