Types of diabetes
Type 1 diabetes
Type 1 diabetes (formerly known as
insulin-dependent diabetes, childhood diabetes, or juvenile-onset
diabetes) is most commonly diagnosed in children and adolescents,
but can occur in adults, as well. It is characterized by ß-cell
destruction, which usually leads to an absolute deficiency of
insulin. Most cases of type 1 diabetes are immune-mediated
characterized by autoimmune destruction of the body's ß-cells in the
Islets of Langerhans of the pancreas, destroying them or damaging
them sufficiently to reduce insulin production. However, some forms
of type 1 diabetes are characterized by loss of the body's ß-cells
without evidence of autoimmunity. Lifestyle does not affect the
probability of getting Type 1 diabetes.
Currently, type 1
diabetes is treated with insulin injections, lifestyle adjustments
(diet and exercise), and careful monitoring of blood glucose levels
using blood testing monitors
Type 2 diabetes
In type 2 diabetes insulin levels are
initially normal or even elevated, but peripheral tissues lose
responsiveness to insulin (known as "insulin
resistance").
Drugs like metformin may be prescribed to
decrease inappropriate mobilization of glucose from liver stores.
Type 2 diabetes is a more complex problem than type 1 but is often
easier to treat, since insulin is still produced, especially in the
initial years; insulin levels may drop later in the course. Type 2
diabetes may go unnoticed for years in a patient before diagnosis,
since the symptoms are typically milder (no ketoacidosis) and can be
sporadic. However, severe complications can result from unnoticed
type 2 diabetes, including renal failure and coronary artery
disease.
Type 2 diabetes is usually first treated by changes
in physical activity (increase), diet (decrease calories and avoid
junk foods), and through weight loss. These can restore insulin
sensitivity, even when the weight loss is modest, e.g., around 5 kg
(10 to 15 lb). The next step, if necessary, is treatment with oral
antidiabetic drugs: the sulphonylureas, metformin, or
thiazolidinediones or some combination of them. If these fail,
insulin therapy will be necessary to maintain normal or near normal
glucose levels. A disciplined regimen of blood glucose checks is
recommended in most cases, particularly when taking medication.
Gestational diabetes
Gestational diabetes mellitus occurs in
about 2%?5% of all pregnancies. It is temporary, and fully
treatable, but, if untreated, may cause problems with the pregnancy,
including macrosomia (high birth weight) of the child. It requires
careful medical supervision during the pregnancy. In addition, about
20%?50% of these women go on to develop type 2
diabetes.
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