Type 1 diabetes : formerly known as insulin-dependent diabetes (IDDM):
Insulin treatment is required to sustain life. There is an absolute insulin deficiency due to the immune destruction of pancreatic beta-cells possibly triggered in genetically
susceptible persons by a viral infection (e.g. congenital rubella), consumption of cows milk early in life, or possibly by chemical toxins. The onset of type 1 diabetes is
abrupt with severe symptoms, often including ketosis.
Type 1 diabetes is the commonest form of diabetes among children and young adults in European countries but has a low prevalence in tropical countries.
Type 2 diabetes : formerly known as non-insulin dependent diabetes (NIDDM):
Individual or ethnic genetic factors lead to susceptibility.
There is some secretion of insulin but a decrease in insulin action (insulin resistance). Several factors are associated
with the development of type 2 diabetes in susceptible individuals. These include dietary changes, overnutrition
with increased intake of saturated fats and decreased intake of dietary fibre, obesity, physical inactivity, and ageing. There is often arterial hypertension and
dyslipidaemia. Some drugs and hormones can also cause glucose intolerance and diabetes.
Malnutrition-related diabetes mellitus (MRDM):
MRDM is a controversial entity, and current WHO classifications of diabetes does not include MRDM. It is also known as ‘tropical pancreatic diabetes’, and is seen in
localized areas throughout tropical countries. It is related to pancreatic damage and is characterized by young age of
onset and past or present malnutrition. Steatorrhoea may occur due to exocrine pancreatic deficiency. Pancreatic
calcification can occur in some cases. The cause is unknown; toxicity from the cyanide content of the root crop cassava has been suggested but not definitely
substantiated.
Gestational diabetes mellitus (GDM):
This is defined as diabetes first recognized in pregnancy. Glucose values often return to normal postpartum but glucose intolerance and type 2 diabetes may occur later in life.
Other forms of diabetes:
These rarer forms can be found with pancreatic disease, some hormonal diseases and genetic syndromes, abnormalities of insulin or its receptors, and as a result of treatment with certain drugs or exposure to certain chemical
toxins.
See also blood glucose for diabetes diagnosis
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