Diabetes Mellitus Overview

Study Notes

Genetic factors
Autoimmune factors
Environmental factors (e.g., viruses, obesity)
Primarily a disorder of glucose metabolism due to insufficient or absent insulin or ineffective insulin use

Factor	Type 1 DM	Type 2 DM
Age at Onset	More common in young people, but can occur at any age	More common in adults, but can occur at any age. Increasing incidence in children
Onset	Signs and symptoms usually abrupt, although disease process may exist for years	Gradual, may go undiagnosed for years
Prevalence	5%–10% of all DM cases	90%–95% of all DM cases
Endogenous Insulin	Absent	Initially increased, then decreases over time
Environmental Factors	Viruses, toxins	Higher weight, lack of exercise
Islet Cell Antibodies	Often present at onset	Absent
Primary Defect	Absent or minimal insulin production	Insulin resistance, decreased insulin production, changes in adipokine production
Symptoms	Polydipsia, polyuria, polyphagia, fatigue, weight loss	Often none, fatigue, recurrent infections, may have polyuria, polydipsia, polyphagia, blurred vision
Ketosis	Present at onset or during insulin deficiency	Usually not present, but can occur during infection or stress
Insulin Therapy	Required for all	Required for some, progressive disease. Insulin may be added to treatment plan
Body Type	Thin, normal, or obese	Often overweight or obese with visceral adiposity ("apple shape"). May be normal
Nutrition Therapy	Essential	Essential
Vascular & Neurological Complications	Frequent	Frequent