diabetes%20mellitus
DIABETES MELLITUS
Diabetes mellitus (DM) is a heterogenous metabolic disorder characterized by the presence of hyperglycemia with carbohydrate, protein and fat metabolism disturbance which results from defects in either insulin secretion or action.
Patients with DM usually present with polyuria, polydipsia and unexplained weight loss.
Type 1 DM is caused by beta cell destruction which leads to complete insulin deficiency. It may be immune mediated or idiopathic.
Patients may present with ketoacidosis or acute onset of hyperglycemia while other patients may resemble type 2 DM or symptoms of other autoimmune disorders.
Type 2 DM is the most common form of diabetes. It is secondary to defect in insulin secretion concomitant with insulin resistance.
Majority of patients are asymptomatic. Ketoacidosis is uncommon and is usually secondary to stress (eg infection).

Definition

  • A heterogenous metabolic disorder characterized by the presence of hyperglycemia with carbohydrate, protein and fat metabolism disturbance which results from defects in either insulin secretion or action or both
  • Various genetic and environmental factors can cause progressive loss of β-cell mass and/or function that manifests clinically as hyperglycemia in both type 1 and 2 diabetes mellitus
    • When hyperglycemia occurs, patients with both type 1 and 2 diabetes mellitus are at risk of developing the same complications but with different rates of occurrence as well as progression
    • Better characterization of the many paths to β-cell dysfunction is required in the identification of individualized therapies for diabetes

Signs and Symptoms

  • Patients usually present with polyuria, polydipsia and unexplained weight loss

Type 1 Diabetes Mellitus

  • Most patients present with ketoacidosis or acute onset of hyperglycemia
  • Other patients have presentation similar to type 2 diabetes mellitus
    • Patients may have late onset and slow disease progression
  • Patients may also have other autoimmune disorders (eg Graves’ disease, Hashimoto’s thyroiditis, Addison’s disease)

Type 2 Diabetes Mellitus

  • Majority of patients are asymptomatic
  • Ketoacidosis is uncommon and usually secondary to stress (eg infection)
  • Diagnosis may not be obvious until complications have appeared
    • Hyperglycemia develops gradually and during early stage, symptoms are often not severe enough for the patient to recognize
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
07 Oct 2019
In pancreatic cancer patients undergoing chemotherapy, the presence of diabetes mellitus is associated with reduced survival and larger tumour, as well as with increased risk of death after treatment, according to a meta-analysis.
Stephen Padilla, 07 Oct 2019
Almost half of Asian patients with dyslipidaemia and hypertension, as well as half of those on pharmacotherapy, have achieved their blood pressure (BP) treatment goals, a Singapore study has shown. Moreover, BP goal attainment is significantly associated with type 2 diabetes mellitus (T2DM) and low-density lipoprotein (LDL-C) control.