كيفية تحضير كوب الشاي الاخضر: طريقة عمل كوب الشاي الاخضر

Diabetes mellitus: Definition and Classification

Definition

Diabetes mellitus is heterogeneous metabolic disorders which is characterized by chronic hyperglycemia due to a disturbed insulin secretion or a disturbed insulin effect or usually both.¹

Classification 

      1. Type 1 DM "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".

This results from β-Cell Destruction, Usually Leading to Absolute Insulin Deficiency).

       2. Type 2 DM "non-insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".

This type of diabetes has insulin resistance and usually have relative (rather than absolute) insulin deficiency.

This is due to insulin resistance, as result of obesity and advanced age.

       3. Gestational diabetes, is the third main and defined as any degree of glucose intolerance with onset or first recognition during pregnancy.

      4.   Other Specific Types of Diabetes

   Ø  Genetic Defects of the b-Cell

   Ø  Genetic Defects in Insulin Action

   Ø  Endocrinopathies

1. Acromegaly

 2. Cushing’s syndrome

3. Glucagonoma

4. Pheochromocytoma

5. Hyperthyroidism

 6. Somatostatinoma

7. Aldosteronoma

   Ø  Drug- or Chemical-Induced Diabetes

Many drugs can impair insulin secretion. Certain toxins such as Vacor (a rat poison) and intravenous pentamidine can destroy pancreatic β-cells.

Many drugs and hormones can impair insulin action e.g. nicotinic acid and glucocorticoids. Patients receiving a-interferon have been reported to develop diabetes associated with islet cell antibodies and, in certain instances, severe insulin deficiency.

   Ø  Infections

Certain viruses have been associated with β-cell destruction. Diabetes occurs in patients with congenital rubella, coxsackievirus B, cytomegalovirus, adenovirus, and mumps have been implicated in diabetes mellitus development.

  Ø  Other Genetic Syndromes Sometimes Associated with Diabetes

These include the chromosomal abnormalities of Down syndrome, Klinefelter syndrome, and Turner syndrome. Wolfram syndrome is an autosomal recessive disorder characterized by insulin-deficient diabetes and the absence of β-cells at autopsy. Additional manifestations include diabetes insipidus, hypogonadism, optic atrophy, and neural deafness (2).

 

References

      1.  Petersmann A et al. Definition, Classification and Diagnosis. Exp Clin Endocrinol Diabetes 2019; 127 (Suppl 1): S1–S7.

2.      American Diabetes Association, Diagnosis and Classification of Diabetes Mellitus. Diabetes Care Volume 37, Supplement 1, January 2014