Classification of Diabetes Mellitus.





Type 1 diabetes (β-cell destruction): Immune-mediated, Idiopathic

Type 2 diabetes (insulin resistance with relative insulin deficiency)

Maturity-onset diabetes of the young (MODY), caused by mutations in:
Hepatocyte nuclear factor (MODY1)
Glucokinase (MODY2)

Genetic defects in insulin processing or insulin action

Defects in proinsulin conversion
Insulin gene mutations
Insulin receptor mutations

Exocrine pancreatic defects

Chronic pancreatitis
Pancreatectomy
Neoplasia
Cystic fibrosis
Hemachromatosis

Endocrinopathies

Acromegaly
Cushing syndrome
Hyperthyroidism
Pheochromocytoma
Glucagonoma

Infections

Cytomegalovirus
Coxsackie virus B

Drugs: Glucocorticoids, Thyroid hormone, Protease inhibitors, b-adrenergic agonists, Thiazides, Nicotinic acid, Phenytoin

Genetic syndromes associated with diabetes

Down syndrome
Kleinfelter syndrome
Turner syndrome

Gestational diabetes mellitus.


Dx of DM:(diagnosis of Diabetes Mellitus)

A random blood glucose concentration of 200 mg/dL or higher, with classical signs and symptoms

A fasting glucose concentration of 126 mg/dL or higher on more than one occasion, or

An abnormal oral glucose tolerance test (OGTT), in which the glucose concentration is 200 mg/dL or higher 2 hours after a standard carbohydrate load (75 gm of glucose.

Pt with impaired glucose tolerance have a significant risk of progressing to overt diabetes.

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