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Classic symptoms of hyperglycemia include polyuria, polydipsia, and unexplained weight loss. Symptoms of hyperglycemia and a casual (random) plasma glucose ≥200 mg/dl are also indicative of DM. 3.Īn oral glucose tolerance test (OGTT) with a plasma glucose ≥200 mg/dl 2 hr after a 75 g (100 g for pregnant women) glucose load. Fasting is defined as no caloric intake for at least 8 hr. 2.Ī fasting plasma glucose (FPG) ≥126 mg/dl, which should be confirmed with repeat testing on a different day. This test is preferred because of ease of administration and reliability. ĭiabetes mellitus can be diagnosed by the following tests: 1.Ī hemoglobin A 1c (HbA 1c) value ≥6.5% is considered diagnostic for diabetes.Ī classification of diabetes mellitus is shown in Box 1.Rare autoimmune (e.g., type A and B insulin resistance syndrome)
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Other rare genetic disorders (e.g., mitochondrial diabetes MELAS syndrome) 5. Pancreatic disease or resection (e.g., cystic fibrosis) b.Ĭhronic excessive corticosteroid exposure or Cushing syndrome c. This form is most common under age 40, in those of African or Afro-Caribbean origin, and in obese or overweight patients. It presents with ketoacidosis requiring insulin, then regains beta cell function and patient is able to discontinue insulin.
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Ketosis-prone diabetes: Relapsing/remitting beta cell function with slow deterioration over time. MODY 1, 2, 3, 4, and 5 (with 3 being most prevalent: 70% incidence with HNF-1-alpha genetic expression) b. These have various genetic expressions and can be classified into various subtypes: a. These individuals are typically not insulin dependent initially and are often misclassified as having type 2 DM. LADA: Latent autoimmune diabetes of adult onset (sometimes called type 1.5 DM). The classification of diabetes also includes: 1. Some type 1 diabetics also may exhibit high levels of glucagon and not all type 1 diabetics have complete islet cell destruction.
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One difference is that type 1 has usually complete or near-total knockout of insulin reserves mediated solely by immunogenic responses from carriers of certain genotypes, whereas type 2 is of polygenetic origin and may have patients who may start with hyperinsulinemia but have insulin resistance and through environmental factors such as diet and sedentary lifestyle leads to an imbalance between glucagon and insulin levels, resulting in combination of causes toward hyperglycemia. Tables 1 and 2 provide a general comparison of the two types of DM. Immune-mediated type 1 DM (type 1A) represents 5% to 10% of newly diagnosed diabetics. The terms insulin-dependent and non–insulin-dependent diabetes are obsolete because when a person with type 2 diabetes needs insulin, he or she remains labeled as type 2 and is not reclassified as type 1. It is broadly classified into type 1 (T1DM) and type 2 DM (T2DM). Diabetes mellitus (DM) refers to a syndrome of hyperglycemia resulting from many different causes (see “Etiology”).