Classification of Diabetes Mellitus
المؤلف:
Marcello Ciaccio
المصدر:
Clinical and Laboratory Medicine Textbook 2021
الجزء والصفحة:
p387
2025-10-16
246
Since the term “diabetes mellitus” encompasses a group of metabolic disorders that share hyperglycemia, over the decades, these clinical conditions have been classified according to different criteria.
In 1979, a treatment-based classification of the various forms of diabetes was proposed. It distinguished between insulin-dependent type 1 diabetes mellitus (IDDM) and non- insulin- dependent type 2 diabetes mellitus (NIDDM). In 1997, following advances in the understanding of the etiology and pathogenesis of diabetes, the American Diabetes Association (ADA) revised this classification and decided to eliminate the terms insulin-dependent and non-insulin- dependent and the related acronyms (IDDM and NIDDM). On the other hand, the terms type 1 and type 2 diabetes mellitus are maintained, thus achieving a classification based on etiology. Currently, international guidelines classify diabetes mellitus into:
– Type 1 diabetes: It is an autoimmune disease caused by β-cell destruction. It is characterized by an absolute insulin deficiency (the latent autoimmune diabetes in adults (LADA) variant), has a slow course, and appears in adults.
– Type 2 diabetes: It is caused by insulin resistance and β-cell dysfunction.– Gestational diabetes: It is diagnosed during pregnancy, and must be distinguished from overt diabetes. Gestational diabetes is caused by functional defects simi lar to type 2 diabetes; it is first diagnosed during pregnancy (commonly between the second and third trimesters) and usually regresses after delivery and then recurs, often at a distance, with the characteristics of type 2 diabetes.
Other types of diabetes may be due to genetic defects of the β-cells of the pancreas, such as maturity-onset diabetes of the young (MODY), a form of type 2 diabetes with juvenile onset; intake of drugs or toxic substances; genetic defects of insulin action; infections; diseases of the exocrine pancreas; alterations of the immune system (rare forms); endocrinopathies; and rare genetic syndromes.
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