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Types Of Diabetes
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Old 11.07.2006, 06:15 PM
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Christopher
 
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Default Types Of Diabetes

Types of Diabetes


Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes accounts for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may be autoimmune, genetic, or environmental. There is no known way to prevent type 1 diabetes. Several clinical trials of methods of the prevention of type 1 diabetes are currently in progress or are being planned.

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications. Clinically-based reports and regional studies suggest that type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently, particularly in American Indians, African Americans, and Hispanic/Latino Americans.

Gestational diabetes is a form of glucose intolerance diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5–10 years. 70% of women who have had gestational diabetes will develop type 2 diabetes at some point during there lifetime.

Other types of diabetes result from specific genetic conditions (such as maturity-onset diabetes of youth), surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes account for 1% to 5% of all diagnosed cases.

Pre-diabetes is a condition that raises the risk of developing type 2 diabetes, heart disease, and stroke. People with pre-diabetes have blood glucose levels higher than normal but not high enough to be classified as diabetes.
  • People with pre-diabetes have impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Some people have both IFG and IGT.
  • IFG is a condition in which the fasting blood glucose level is 100 to 125 milligrams per deciliter (mg/dL) after an overnight fast. The level is higher than normal but not high enough to be classified as diabetes.
  • IGT is a condition in which the blood glucose level is 140 to 199 mg/dL after a 2-hour oral glucose tolerance test. This level is higher than normal but not high enough to be classified as diabetes.
  • In a cross-section sample of U.S. adults aged 40-74 years tested from 1988 to 1994, 33.8% had IFG, 15.4% had IGT, and 40.1% had pre-diabetes (IGT or IFG or both). Applying these percentages to the entire U.S. population in 2000, an estimated 35 million adults aged 40-74 had IFG, 16 million had IGT, and 41 million had pre-diabetes (there is overlap between the IFG and IGT groups).
  • Progression to diabetes among those with pre-diabetes is not inevitable. Studies have shown that people with pre-diabetes who lose weight and increase their physical activity can prevent or delay diabetes and even return their blood glucose levels to normal.
  • More recent estimates from 1999-2002 indicate that, among US adults age 20 years and older, 26% had IFG, which was similar to the prevalence in 1988-1994 (25%). Applying this percentage to the entire U.S. population, 54 million American adults had IFG in 2002. Because IGT was not measured in 1999-2002, these data suggest that at least 54 million American adults had pre-diabetes in 2002.
  • 2 million adolescents aged 12-19 (1 in 6 overweight adolescents aged 12-19) have pre-diabetes.
Who is at Greater Risk for Type 1 Diabetes?

  • Siblings of people with type 1 diabetes
  • Children of parents with type 1 diabetes
Who is at Greater Risk for Type 2 Diabetes?

  • People with impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG)
  • People over age 45
  • People with a family history of diabetes
  • People who are overweight
  • People who do not exercise regularly
  • People with low HDL cholesterol or high triglycerides, high blood pressure
  • Certain racial and ethnic groups (e.g., Non-Hispanic Blacks, Hispanic/Latino Americans, Asian Americans and Pacific Islanders, and American Indians and Alaska Natives)
  • Women who had gestational diabetes, or who have had a baby weighing 9 pounds or more at birth
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Christopher Berry
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Report of the Expert Committee on Diagnosis & Classification of Diabetes Mellitus
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Old 02.20.2007, 09:16 AM
sstrumello sstrumello is offline
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Post Report of the Expert Committee on Diagnosis & Classification of Diabetes Mellitus

If there is any question on the definition on diabetes types, it is worth noting that an international Expert Committee, working under the sponsorship of the American Diabetes Association, was established in May 1995 to review the scientific literature since 1979 and to decide if changes to the classification and diagnosis of diabetes were warranted. The Committee met on multiple occasions and widely circulated a draft report of their findings and preliminary recommendations to the international diabetes community.

In 2003, the Committee discussed and revised numerous drafts of a manuscript that culminated in this published document: Diabetes Care 26:S5-S20, 2003. Since that time, no further updates have been incorporated, although more recently, based on a review of the major medical journals, some doctors have suggested that it might be time to revisit the issue once again.
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Type 1 since September 1976 (dx'd age 7). Now age 37. Blog: http://sstrumello.blogspot.com/. Yahoo Group: http://health.groups.yahoo.com/groups/DiabetesPortal. NYC Advocacy Website:
http://www.stopnyca1ctracking.org.
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