1. IDDM (Type -1) Insulin dependent diabetes
mellitus: It
is severe form of diabetes mellitus, it occurs in juvenile period i.e. child
& younger. Here, circulating insulin is virtually absent because β cell are
damaged & β cell failed to secrete enzyme.
Criteria:
- Autoimmune type is commoner than idiopathic type
- Age <30yrs
- Abrupt onset
- Not obese when they first develop symptom
- Polyuria, polydipsia, polyphagia
- Due to absolute deficiency of insulin resulting form autoimmune destruction of beta cell
- Treatment – diet control and insulin
- Without insulin the treatment of such patient will die ultimately with diabetic ketoacidosis
- Diabetic ketoacidosis only occur in type I
2. NIDDM (Type-2) or maturity onset DM: It is milder form of
diabetes, it occurs in adult. Here circulating insulin level is present but
insufficient to reduce blood sugar level.
Criteria:
- Have genetic predisposition – about 90-95% sufferer have family history
- Age > 40
- Gradual onset
- Usually obese
- Usually asymptomatic
- Due to both by insulin resistance and impaired insulin secretion
- Treatment:
o Initially diet control alone
o Diet control + oral
hypoglycemic drug
o 1/3rd patient
require insulin
§ Ketoacidosis is usually
absent
3. Type – 3
mellitus:
i.
Drugs –
§ Corticosteroids
§ Thiazide
diuretics
§ Phenytoin
ii.
Some non pancreatic disease –
§ Acromegaly
§ Cushing’s
syndrome
§ Pheocromocytoma
§ Hyperthyroidism
4.
Type 4 DM:
- It is known as gestational diabetes (GDM)
- GDM is defined as any abnormality in glucose level for the 1st time during pregnancy
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