1/3/2024 0 Comments Bookshelf 2![]() ![]() The rate of destruction is generally rapid in children and faster in adults. It occurs in adulthood, often with a slower course of onset. The significant determinants are polymorphisms of class II HLA genes encoding DQ and DR4-DQ8, with DR3-DQ2, found in 90% of T1DM patients.Īnother form of T1DM is latent autoimmune diabetes of adults (LADA). The major histocompatibility complex (MHC), also known as human leukocyte antigens (HLA), is reported to account for approximately 40 to 50% of the familial aggregation of T1DM. T1DM has a strong genetic predisposition. In T1DM, there is cellular-mediated, autoimmune destruction of pancreatic beta cells. Secondary diabetes is caused due to the complication of other diseases affecting the pancreas (for example, pancreatitis), hormone disturbances (for example, Cushing disease), or drugs (for example, corticosteroids). MODY is a familial disorder and usually presents under the age of 25 years. Around 1 to 5% of all diabetes cases are due to monogenic diabetes. Examples of monogenic diabetes include conditions like neonatal diabetes mellitus and maturity-onset diabetes of the young (MODY). Older age, obesity, excessive gestational weight gain, history of congenital anomalies in previous children, or stillbirth, or a family history of diabetes are risk factors for GDM.Ī single genetic mutation in an autosomal dominant gene causes this type of diabetes. Even after birth, such infants may have respiratory distress syndrome and subsequent childhood and adolescent obesity. The fetus can have increased weight and size (macrosomia) or congenital anomalies. GDM can be complicated by hypertension, preeclampsia, and hydramnios and may also lead to increased operative interventions. Women with GDM and their offspring have an increased risk of developing type 2 diabetes mellitus in the future. According to the American Diabetes Association (ADA), GDM complicates 7% of all pregnancies. Although it can occur anytime during pregnancy, GDM generally affects pregnant women during the second and third trimesters. Hyperglycaemia, which is first detected during pregnancy, is classified as gestational diabetes mellitus (GDM), also known as hyperglycemia in pregnancy. Still, it is increasingly seen in children, adolescents, and younger adults due to rising levels of obesity, physical inactivity, and energy-dense diets. T2DM is most commonly seen in persons older than 45 years. During this state, insulin is ineffective and is initially countered by an increase in insulin production to maintain glucose homeostasis, but over time, insulin production decreases, resulting in T2DM. In T2DM, the response to insulin is diminished, and this is defined as insulin resistance. Type 2 diabetes mellitus (T2DM) accounts for around 90% of all cases of diabetes. T1DM is most commonly seen in children and adolescents though it can develop at any age. A combination of genetic susceptivity and environmental factors such as viral infection, toxins, or some dietary factors have been implicated as triggers for autoimmunity. As a result, there is an absolute deficiency of insulin. Type 1 diabetes mellitus (T1DM) accounts for 5% to 10% of DM and is characterized by autoimmune destruction of insulin-producing beta cells in the islets of the pancreas. Some other less common types of diabetes include monogenic diabetes and secondary diabetes. In this review, we provide an overview of the pathogenesis, diagnosis, clinical presentation, and principles of management of diabetes.ĭM is broadly classified into three types by etiology and clinical presentation, type 1 diabetes, type 2 diabetes, and gestational diabetes (GDM). Chronic hyperglycemia in synergy with the other metabolic aberrations in patients with diabetes mellitus can cause damage to various organ systems, leading to the development of disabling and life-threatening health complications, most prominent of which are microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular complications leading to a 2-fold to 4-fold increased risk of cardiovascular diseases. DM is proving to be a global public health burden as this number is expected to rise to another 200 million by 2040. According to the International Diabetes Federation (IDF), approximately 415 million adults between the ages of 20 to 79 years had diabetes mellitus in 2015. It may be due to impaired insulin secretion, resistance to peripheral actions of insulin, or both. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia.
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