Diabetes mellitus type NIDDM

The other type of diabetes mellitus, type II, is far more common. In contrast, type II is not an autoimmune process and may or may not be insulin dependent that is, a diabetic state that is most effectively managed by insulin therapy. Frequently, NIDDM is used interchange-... 

T Diabetes mellitus, caused by a deficiency in the secretion or action of insulin, is a relatively common disease nearly 6% of the United States population shows some degree of abnormality in glucose metabolism that is indicative of diabetes or a tendency toward the condition. There are two major clinical classes of diabetes mellitus type I diabetes, or insulin-dependent diabetes mellitus (IDDM), and type II diabetes, or non-insulin-dependent diabetes mellitus (NIDDM), also called insulin-resistant diabetes. 

Type II diabetes mellitus Type II diabetes mellitus (age-onset diabetes) is when the pancreas ability to produced insulin is either diminished (age) or is insufficient to metabolize the excess serum glucose (overweight, lack of exercise). Insulin is produced but is not effective. The patient controls Type II diabetes mellitus by diet, exercise, and oral diabetes medication that stimulate insulin production in the pancreas and other organs. This is referred to as non-insulin-dependent diabetes (NIDDM). 

There are multiple causes of diabetes. Whereas the molecular bases of some forms of diabetes are well understood, in many cases etiologies are unknown. It is customary to divide diabetes into two main forms insulin-dependent diabetes mellitus (IDDM), also referred to as Type I or juvenile-onset diabetes, and noninsulin-dependent diabetes mellitus (NIDDM), also called Type II or maturity-onset diabetes (3). 

Type 2—Noninsulin-dependent diabetes mellitus (NIDDM). Fonner names of this type of diabetes mellitus include maturity-onset diabetes, adult-onset diabetes, and stable diabetes. 

Type 2 Peripheral tissue resistance to the action of insulin Insulin secretory defects Includes those formerly classified as adult onset diabetes, type II DM or non-insulin dependent diabetes mellitus (NIDDM). Ketosis is rare. 

Another form of diabetes is non-insulin-dependent diabetes mellitus (NIDDM, or adult diabetes, or type II diabetes). In this case, insulin is produced and a normal insulin level is detected in blood. But for various reasons its effect is reduced. This may be caused by a reduced number of insulin receptors on cells, or reduced effectiveness in binding to these receptors. The cause is complex and may involve genetic make-up, changes in lifestyle, nutritional habits, and environmental factors. 

In patients with type 1 insulin-dependent diabetes mellitus not adequately treated with insulin, fatty add release from adipose tissue and ketone synthesis in the liver exceed the ability of other tissues to metabolize them, and a profound, life-threatening ketoaddosis may ocxnir. An infection or trauma (causing an increase in cortisol or epinephrine) may predpitate an episode of ketoaddosis. Patients with type 2 non-insulin-dependent diabetes meUitus (NIDDM) are much less likely to show ketoaddosis. The basis for this observation is not completely understood, although type 2 disease has a much slower, insidious onset, and insulin resistance in the periphery is usually not complete. Type 2 diabetics can develop ketoacidosis after an infection or trauma. In certain populations with NIDDM, ketoaddosis is much more common than previously appredated. 

Diabetes mellitus is a very common metabolic disease that is caused by absolute or relative insulin deficiency. The lack of this peptide hormone (see p. 76) mainly affects carbohydrate and lipid metabolism. Diabetes mellitus occurs in two forms. In type 1 diabetes (insulin-dependent diabetes mellitus, IDDM), the insulin-forming cells are destroyed in young individuals by an autoimmune reaction. The less severe type 2 diabetes (non-insulin-dependent diabetes mellitus, NIDDM) usually has its first onset in elderly individuals. The causes have not yet been explained in detail in this type. 

In the case of NIDDM (maturity onset or type II diabetes mellitus), insulin is present in the blood at normal (or even elevated) levels, but fails to promote any of its characteristic effects. A number of factors can contribute to such insulin resistance, including ... 

Oral antidiabetic agents might be indicated in noninsulin dependent diabetes mellitus (NIDDM), i.e. diabetes Type II where insulin resistance caused by down-regulation of insulin receptors or a failure of the pancreas to release insulin even though it is formed, play a role. However, oral antidiabetic... 

Diabetes mellitus has been traditionally classified into insulin-dependent diabetes mellitus (IDDM), also known as type I (formerly called juvenile-onset diabetes mellitus), and non-insulin-dependent diabetes mellitus (NIDDM), also known as type II (formerly referred to as adult-onset diabetes mellitus). There are clearly varying degrees of overlap, and though it is often important to know whether a particular individual possesses relative insulin deficiency or relative insulin resistance or both, some of the more salient differences between IDDM and NIDDM are summarized in Table 67.1. 

Treating Diabetes Mellitus. There are two main types of diabetes. Type I diabetes (previously called insulin-dependent diabetes mellitus, IDDM) is a severe form which occurs most commonly in juveniles and young adults and which results from an absolute insulin deficiency arising from pancreatic B cell destruction, presumably via an immune-mediated mechanism. Type II diabetes (previously called non-insulin-dependent diabetes mellitus, NIDDM) is a milder, heterogeneous form of diabetes which occurs more... 

Over 5% of the population of western nations is afflicted with diabetes. TTie most prevalent form of diabetes, non-insulin-dependent diabetes mellitus (NIDDM, or type 11), is commonly associated with obesity and hypertension, and is believed to be the consequence of altered insulin action or insulin secretion (for review see Defronzo, 1988 Defronzo and Ferrannini, 1991). Insulin-dependent diabetes mellitus (IDDM, or type 1 diabetes) accounts for approximately 10% of all cases of diabetes. IDDM is characterized by specific destruction of insulin secreting /3-cells found in islets of Langerhans. Destruction of 80-90% of islet /3-cells causes insulin deficiency and the inability to regulate blood glucose levels. 

Chiasson JL et al Acarbose for prevention of type 2 diabetes mellitus The STOP-NIDDM randomized trial. Lancet 2002 359 2072. [PMID 12086760]... 

Adults seldom develop type I diabetes but often suffer from type II or non-insulin-dependent diabetes mellitus (NIDDM). This is not a single disease but a syndrome with many causes. There is... 

Type 2, also known previously as non-insulin-dependent diabetes mellitus (NIDDM), accounts for 90 to 95 percent of persons with diabetes mellitus.19 This form of diabetes usually occurs in adults, especially in older individuals.35,102 Type 2 diabetes, however, can also occur in young people, and there is concern that the incidence of this disease is increasing dramatically in children and adolescents.9,83 Although the specific factors responsible for this disease are unknown, a genetic predisposition combined with poor diet, obesity, and lack of exercise all seem to contribute to the onset of type 2 diabetes.50,81,83 Increased body weight is common in patients with type 2 diabetes. 

Non-insulin-dependent diabetes mellitus (NIDDM), also known as late-onset or type II diabetes, affects over 12 million Americans, only about half of whom are aware of their disease (H6). Importantly, most diabetics have the disease for 4-7 years before it is diagnosed. About 50% of men and women aged 65-74 years demonstrate glucose intolerance (i.e., increased glucose levels but below that required for a definitive diagnosis) about 20% of these have NIDDM (C3, B16). NIDDM is a major cause of cardiovascular disease, stroke, renal failure, and blindness it is also associated with accelerated aging. 

Diabetes mellitus ( sweet urine ) involves relative over-production of glucose by the liver and under-utilization by other organs. Diabetes is the most serious metabolic disease in terms of its social impact. Obesity and the indulgent Western diet correlates with mature age diabetes. Type 1 diabetes (juvenile diabetes) typically manifests at less than 20 years from autoimmune destruction of the insulin-producing pancreatic (3 cells. Type 1 diabetes is insulin-dependent diabetes mellitus (IDDM) and is fatal without exogenous insulin. Type 2 diabetes mellitus (mature age diabetes) occurs later in life and typically involves both deficient insulin production and insulin resistance , that is, the target cells are less responsive to insulin. Type 2 diabetes is initially non-insulin-dependent diabetes (NIDDM) but insulin therapy (in addition to oral antidiabetics) may eventually be required. Hyperglycaemia due... 

Diabetes mellitus (DM) is an increasingly common disease of sugar metabolism. Juvenile-onset diabetes, also known as Type I or insulin-dependent diabetes (IDDM), is an autoimmune disease that results in decreased release of insulin by the pancreas. Late-onset diabetes, also known as Type II or non-insulin-dependent diabetes (NIDDM), results from reduced sensitivity of cells to the insulin signal. A convenient animal model for studying diabetes and testing alternative therapies is the streptozotocin-freated diabetic rat. Streptozotocin (STZ) attacks the pancreas and decreases insulin production and release, thus, mimicking many aspects of the human disease. Since insulin is not orally absorbed, the oral administration of vanadium compounds that are insuhn-mimetic or insulin-enhancing would be a very attractive therapy ... 

Type 2 (formerly, non-insulin dependom diabetes mellitus, NIDDM), which typic.illy occurs in older, often obese people who retain capacity to secrete insulin but who arc resistant to its. action.Those terms and abbreviations are used in this ciiaptei. ... 

An over iew of the di ease diabetes mellitus will be used to supply motivation prior to starling our journey through the pathways of energy production. Diabetes mellitus is a major health concern on a global basis. This disease takes two forms, i-e-, insulin-dependent diabetes mellitus (IDDM) and nan-insulin-dependent diabetes mellitus (NIDDM). Nutritional intervention is used in the treatment of diabetes, as revealed later in this chapter and in the Obesity chapter. IDDM is easily treated by injections of insulin, while NIDDM is more difficult to tneat. NIDDM is treated with insulin and by weight reduction in obese patients. Use of soluble fiber in the diet may be used in the treatment of both types of diabetes. 

NIDDM, also called Type II diabetes, generally presents in persons over 30 years of age. NiODM is associated with obesity Perhaps two-thirds of all persons with NIDDM are also obese. The overall defect in NIDDM is that the muscle and adipose tissue tend not to respond to insulin. NIDDM is a product of multiple biochemical defects that result in impaired glucose metabolism. Apparently, each of these defects accounts for no more than 5 10% of the population of those with NIDDM. NIDDM develops initially because of defects in insulin s ability to transmit a signal rather than by a lack of insulin in the bloodstream, and for this reason the disease is called non-insulin-depcndcnl diabetes mellitus. 

Measurement of the waist-to-hip ratio has proven to be useful in diagnosing male-type or female-t3q>e obesity. This ratio is acquired by measuring the circumference around the waist, and about the hips, and performing division. The units of each measurement is centimeters, while the ratio has no unit. A waist/hip ratio of 1.0 or greater (for men) or 0.8 or greater (for women) is associated with a distinct increase in health risk for non-insulin-dependent diabetes mellitus (NIDDM), hypertension, and atherosclerosis (Bjomtorp, 1985). 

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