Diabetes mellitus type natural history

FIGURE 40-1 Scheme of the natural history of the (3-cell defect in type 1 diabetes mellitus. (Used, with permission, from DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiological Approach. 6th ed. New York McGraw-Hill 2005, Fig. 72M, p. 1339.) yr, year. 

The natural history of Type-II diabetes mellitus is characterized by a progression of B-cell dysfunction. Many patients are initially well controlled by diet but, as the years go by, they need oral hypoglycaemic agents and eventually insulin for satisfactory glycaemic control. Some 17% of all Type-II diabetics are treated with insulin, and 5% of Type-II diabetics are switched to insulin each year (Marble and Camerini-Davalos, 1961). The point at which a patient should be put on a insulin regimen, however, is not always easy to assess and may be determined by life expectancy, morbidity and compliance of the patient. 

Weyer C, Bogardus C, Mott DM, Pratley RE. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J Clin Invest 1999 104(6) 787-794. 

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