Causes of Diabetes mellitus
Diabetes mellitus is classified
into four broad categories: type 1, type 2, gestational diabetes, and
"other specific types". The "other specific types" are a
collection of a few dozen individual causes.
into four broad categories: type 1, type 2, gestational diabetes, and
"other specific types". The "other specific types" are a
collection of a few dozen individual causes.
Diabetes is a more variable
disease than once thought and people may have combinations of forms. The term
"diabetes", without qualification, usually refers to diabetes
mellitus.
disease than once thought and people may have combinations of forms. The term
"diabetes", without qualification, usually refers to diabetes
mellitus.
Causes of Diabetes mellitus Type 1
Type 1 diabetes mellitus is
characterized by loss of the insulin-producing beta cells of the islets of
Langerhans in the pancreas, leading to insulin deficiency. This type can be
further classified as immune-mediated or idiopathic.
characterized by loss of the insulin-producing beta cells of the islets of
Langerhans in the pancreas, leading to insulin deficiency. This type can be
further classified as immune-mediated or idiopathic.
The majority of type 1 diabetes
is of the immune-mediated nature, in which a T-cell-mediated autoimmune attack
leads to the loss of beta cells and thus insulin. It causes approximately 10%
of diabetes mellitus cases in North America and Europe.
is of the immune-mediated nature, in which a T-cell-mediated autoimmune attack
leads to the loss of beta cells and thus insulin. It causes approximately 10%
of diabetes mellitus cases in North America and Europe.
Most affected people are
otherwise healthy and of a healthy weight when onset occurs. Sensitivity and
responsiveness to insulin are usually normal, especially in the early stages.
Type 1 diabetes can affect children or adults, but was traditionally termed
"juvenile diabetes" because a majority of these diabetes cases were
in children.
otherwise healthy and of a healthy weight when onset occurs. Sensitivity and
responsiveness to insulin are usually normal, especially in the early stages.
Type 1 diabetes can affect children or adults, but was traditionally termed
"juvenile diabetes" because a majority of these diabetes cases were
in children.
"Brittle" diabetes,
also known as unstable diabetes or labile diabetes, is a term that was
traditionally used to describe the dramatic and recurrent swings in glucose
levels, often occurring for no apparent reason in insulin-dependent diabetes.
This term, however, has no biologic basis and should not be used.
also known as unstable diabetes or labile diabetes, is a term that was
traditionally used to describe the dramatic and recurrent swings in glucose
levels, often occurring for no apparent reason in insulin-dependent diabetes.
This term, however, has no biologic basis and should not be used.
Still, type 1 diabetes can be accompanied by
irregular and unpredictable high blood sugar levels, frequently with ketosis,
and sometimes with serious low blood sugar levels. Other complications include
an impaired counterregulatory response to low blood sugar, infection,
gastroparesis (which leads to erratic absorption of dietary carbohydrates), and
endocrinopathies (e.g., Addison's disease). These phenomena are believed to
occur no more frequently than in 1% to 2% of persons with type 1 diabetes.
irregular and unpredictable high blood sugar levels, frequently with ketosis,
and sometimes with serious low blood sugar levels. Other complications include
an impaired counterregulatory response to low blood sugar, infection,
gastroparesis (which leads to erratic absorption of dietary carbohydrates), and
endocrinopathies (e.g., Addison's disease). These phenomena are believed to
occur no more frequently than in 1% to 2% of persons with type 1 diabetes.
Type 1 diabetes is partly
inherited, with multiple genes, including certain HLA genotypes, known to
influence the risk of diabetes. The increase of incidence of type 1 diabetes
reflects the modern lifestyle. In genetically susceptible people, the onset of
diabetes can be triggered by one or more environmental factors, such as a viral
infection or diet.
inherited, with multiple genes, including certain HLA genotypes, known to
influence the risk of diabetes. The increase of incidence of type 1 diabetes
reflects the modern lifestyle. In genetically susceptible people, the onset of
diabetes can be triggered by one or more environmental factors, such as a viral
infection or diet.
Several viruses have been
implicated, but to date there is no stringent evidence to support this
hypothesis in humans. Among dietary factors, data suggest that gliadin (a
protein present in gluten) may play a role in the development of type 1
diabetes, but the mechanism is not fully understood.
implicated, but to date there is no stringent evidence to support this
hypothesis in humans. Among dietary factors, data suggest that gliadin (a
protein present in gluten) may play a role in the development of type 1
diabetes, but the mechanism is not fully understood.
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