Diabetes mellitus classification

Oki. J.C. (1995) Dyslipidemias in patients with diabetes mellitus classification and risks and benefits of therapy. Pharmacotherapy.. 15.317-337. 

Mayfield J. (1998) Diagnosis and classification of diabetes mellitus New criteria. Am Fam Physician 58 1355-1362. 

Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2003 26(Suppl l) S5-24. 

The current classification of diabetes mellitus identifies a group of patients who have virtually no insulin secretion and whose survival depends on administration of exogenous insulin. This insulin-dependent group (type 1) represents 5-10% of the diabetic population in the USA. Most type 2 diabetics do not require exogenous insulin for survival, but many need exogenous supplementation of their endogenous secretion to achieve optimum health. 

Eisenbarth GS Classification, diagnostic tests, and pathogenesis of Type I Diabetes Mellitus, in Becker KL (ed) Principles and Practice of Endocrinology and Metabolism. 3rd ed. Lippin-cott Williams and Wilkins, 2001, pp. 1307-1314. 

Classification of diabetes mellitus Assessment of p-ceU activity Obtain insurance coverage for insulin pump Monitoring therapy Pancreatectomy Transplant (pancreas-islet cell)... 

Approximately 5% to 10% of aU cases of diabetes mellitus are in this category. Patients usually have abrupt onset of symptoms (e.g., polyuria, polydipsia, and rapid weight loss). Patients have insulinopenia (a deficiency of insulin) caused by loss of pancreatic islet (3-ceUs and are dependent on insulin to sustain life and prevent ketosis. Most patients have antibodies that identify an autoimmune process (see later discussion) some patients have no evidence of autoimmunity and are classified as type 1 idiopathic. The peak incidence is in childliood and adolescence. Approximately 75% acquire the disease before age 30 years, but the onset in the remainder may occur at any age. Age at presentation is not a criterion for classification. 

BOX 25-2 Classification of Diabetes Mellitus and Other Categories of Glucose intolerance... 

From the American Diabetes Association. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 1997 20 1183-1201. 

Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications, Part 1 diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998 15 539-53. 

NDDG. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. National Diabetes Data Group. Diabetes 1979 28 1039-57. 

Advanced age, heart rate, systolic blood pressure, diabetes mellitus, recurrent or persistent pain. The prognosis is worse in diabetics and elderly patients, especially in presence of renal failure, sinus tachycardia and evident haemodynamic impairment (hypotension, pulmonary oedema, etc.) (grade 3-4 of Killip classification) (Wiviott et al, 2006). 

The two major classifications of diabetes mellitus are type 1 (insulin deficient) and type 2 (combined Insulin resistance and relative deficiency in insulin secretion). They differ in clinical presentation, onset, etiology, and progression of disease. Both are associated with microvascularand macrovascular disease complications. 

A number of classification schemes have been developed to describe SSTIs. Bacterial infections of the skin can be classified as primary or secondary (Table 108-1). Primary bacterial infections usually involve areas of previously healthy skin and typically are caused by a single pathogen. In contrast, secondary infections occur in areas of previously damaged skin and are frequently polymicrobic. SSTIs are also classified as complicated or uncomplicated. Infections are considered complicated when they involve deeper skin structures (e.g., fascia, muscle layers, etc), require significant surgical intervention, or occur in patients with compromised immune function (e.g., diabetes mellitus, human immunodeficiency virus [HIV] infection, etc). ... 

The least well characterized autoimmune polyglandular syndrome is the type 3 syndrome. This syndrome is defined by the presence of autoimmune thyroid disease with another autoimmune disease, such as diabetes mellitus type l, autoimmune gastritis, or myasthenia gravis, but in the absence of Addison disease. APGS type 3 primarily involves females (the female to male ratio is 7 1) who have HLA-DR3-associated autoimmune disease and is probably the most common of the autoimmune polyglandular syndrome disorders. Since different and multiple clinical combinations can be found, the classification of this type of autoimmune polyglandular syndrome is probably more complicated than originally anticipated. 

The current classification of diabetes was introduced by the National Diabetes Data Group (1979), a division of the National Institutes of Health. Type I, or insulin-dependent diabetes mellitus (IDDM) (formerly named juvenile-onset or ketosis-prone diabetes) and Type II or noninsulin-dependent diabetes mellitus (NIDDM) (formerly known as maturity-onset or adult-onset diabetes). Type II is encountered as a nonobese and obese type, with the latter predominating. 

Treece KA, MacFarlane RM, Pound P, Game FL, Jeffcoate WJ. Validation of a system of foot ulcer classification in Diabetes Mellitus. Diabet. Med. 2004 21 987-991. 

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