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 same complications but with different rates of 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
Jairia Dela Cruz, 11 Jan 2019
Use of standard-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) appears to confer protection against the risk of endometrial cancer in overweight and obese women, according to a meta-analysis.
Tristan Manalac, 11 Jan 2019
Less than 15 percent of Singaporean adolescents get the recommended 8–10 hours of sleep on a school night, reports a recent study, noting that such short sleep duration is linked to symptoms of depression, overweight or obesity, and poorer self-rated health.
04 Jan 2019
Obstructive sleep apnoea may increase the risk of male-pattern baldness in men with a family history of hair loss, and this association appears to be mediated by low serum transferrin saturation levels related to hypoxia, a study suggests.
6 days ago
Airway type 2 inflammation remains persistent in many asthmatics on inhaled corticosteroids, a new study has shown. These patients tend to be older and have a more severe disease.