Diabetes mellitus (DM) is a group of metabolic disorders characterized by increased Blood Sugar Levels for prolonged period of time.Diabetes is a diseases as old as civilization itself.The first recorded refrences are in the Ebers papyrus which is 7000 years old.In india diabetes was described in very clear terms in Susruta around 600 BC and a distinction was made between the two broad catagories.On the basis of pathogenesis involved that leads to increased blood levels two broad catagories of diabetes mellitus are type1 and type2.
Type1 Diabetes:- Type 1 diabetes occurs when the islets of Langerhans (insulin producing cells) are destroyed .In the majority of type1 patients the pathogenesis is autoimmune and in few cases the process is idiopathic (no known cause).The pancreas in type1 Diabetes has a near total lack of beta cells,which leads to low levels of Insulin in the blood (hypoinsulinemia),therefore entire requirement of insulin has to be supplied subcutaneously.Type1 Diabetes is usually diagnosed in childhood or early teenages depending upon the rate of destruction of the beta cells.
Type 2 Diabetes:-Type 2 Diabetes occurs intially due to increased insulin resistance(the cells of the body poorly respond to the insulin).As the disease progresses the beta cell work excessively to meet the insulin demands of the body and the time is reached when beta cells get exhusted characterized by the presence of both the defects ot insulin secretion and insulin resistance.This type of diabetes is usually managed by Oral Hypoglycemic Drugs ,which increase the insulin secretion from beta cells and also decrease the insulin resitance in the body.Type 2 diabetes is caused by a complex interaction of genetic and environmental factors therefore age of onset of diseases is usually >40
Double Diabetes:-What is Double Diabetes? It is also called type 1.5 ,some may even call it as type 3 Diabetes.This condition is actually LADA (latent autoimmune diabetes of adults).the pathogenesis is autoimmune as that of type 1 Diabetes ,then how does it differ from type 1,the differens is in the rate of progression of diseases .People with LADA are initially diagnosed as type 2 because these patients come to diabetic clinic in their thirties due to comparatively slow progression of disease .The patients are initially treated with oral hypoglycemic drugs and their blood sugar levels are well controlled in the begining but as the disease progresses (autoimmune destruction) patients no longer respond to oral hypoglycemic drugs even on higher doses and the patient is ultimately shifted to insulin.
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