Diabetes Mellitus (Types & Complications)

diabetes mellitus (DM)

Hyperglycemia from impaired insulin secretion and/or action; leading cause of blindness, renal failure, gangrene

Type 1 diabetes (IDDM)

10-15% of DM; autoimmune destruction of beta cells; onset <30 years; insulin-dependent

Type 2 diabetes (NIDDM)

Up to 95% of DM; insulin resistance + impaired insulin response; now in obese adolescents/young adults

LADA (Type 1.5)

Latent autoimmune diabetes in adults; same autoantibodies as Type 1; no insulin needed first 6 months

gestational diabetes

~5% of pregnancies; usually resolves after delivery; 30% develop Type 2 within 10 years

MODY (mature-onset diabetes of the young)

Genetically linked; thin people <55 years; may respond to small insulin doses or sulfonylureas

polyuria

Excessive urination (classic hyperglycemia symptom)

polydipsia

Excessive thirst (classic hyperglycemia symptom)

polyphagia

Excessive hunger (classic hyperglycemia symptom)

diabetic ketoacidosis (DKA)

Hyperglycemia + dehydration + metabolic acidosis + ketones; medical emergency; acetone smell on breath

hyperglycemia

High blood glucose; damages capillary endothelial cells (retinopathy, nephropathy, neuropathy)

hypoglycemia

Low blood glucose (<70 mg/dL); brain first organ affected; shakiness, anxiety, confusion, seizure, LOC

insulin shock

Severe medical emergency caused by hypoglycemia

diabetic coma

Severe medical emergency caused by hyperglycemia

retinopathy

85% of diabetics develop some degree; leading cause of blindness

nephropathy

30% of diabetics; can progress to end-stage renal disease

neuropathy

Sensory defects, numbness, tingling, paresthesias in feet/hands