IDDM

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). 

NIDDM is a much more common disease than IDDM, accounting for about 85—90% of all cases of diabetes meUitus. Whereas NIDDM may be present at any age, the incidence increases dramatically with advanced age over 10% of the population reaching 70 years of age has NIDDM. Patients with NIDDM do not require insulin treatment to maintain life or prevent the spontaneous occurrence of diabetic ketoacidosis. Therefore, NIDDM is frequendy asymptomatic and unrecognized, and diagnosis requires screening for elevations in blood or urinary sugar. Most forms of NIDDM are associated with a family history of the disease, and NIDDM is commonly associated with and exacerbated by obesity. The causes of NIDDM are not well understood and there may be many molecular defects which lead to NIDDM. 

Endocrine diseases autoimmune thyreoiditis, primary myxedema, Addison s disease, type 1 diabetes mellitus (IDDM)... 

Type 1 Diabetes (Previonsiy Insnlin-Dependent Diabetes Mellitns, IDDM, or Juvenile Diabetes)... 

Type 1—Insulin-dependent diabetes mellitus (IDDM). Fonner names of this type of diabetes... 

Clarke WL, Cox DJ, Gonder-Frederick LA, Julian D, Schlundt D, Polonsky W. The relationship between no routine use of insulin, food, and exercise and the occurrence of hypoglycemia in adults with IDDM and varying degrees of hypoglycemic awareness and metabolic control. Diabetes Educator 1997 23 55-8. 

GN Glomerulonephritis graduate nurse IDDM Insulin-dependent diabetes mellitus... 

Spielman RS, McGinnis RE, Ewens WJ. Transmission test for linkage disequilibrium the insulin gene region and insulin-dependent diabetes mellitus (IDDM). Am J Hum Genet 1993 52[3] 506-516. 

The answer is a. (Hardman, p 1510.) Although the mechanism of action of metformin and other biguanicies is unclear, biguanides virtually never cause hypoglycemia They operate independently of pancreatic p cells but are not useful in insulin-dependent diabetes mellitus (IDDM). Some possible mechanisms of action are direct stimulation of glycolysis in peripheral tissues, increased sensitivity to insulin, and reduction of glucagon levels. 

Does nitric oxide mediate autoimmune destmction of beta-cells Possible therapeutic interventions in IDDM, Diabetes 41 (1992), p. 897-903... 

H3. Haffner, S. M., Tuttle, K. R., and Rainwater, D. L., Decrease of lipoprotein(a) with improved glycemic control in IDDM subjects. Diabetes Care 14, 302-307 (1991). 

L17. Levitsky, L. L., Scanu, A. M., and Gould, S. H., Lipoprotein(a) levels in black children and adolescents with IDDM. Diabetes Care 14, 283-287 (1991). 

Type 1 Autoimmune disease resulting in an absolute deficiency of insulin. Formerly referred to as juvenile onset diabetes, type I DM or insulin dependent diabetes mellitus (IDDM). Ketosis is common in poorly controlled subjects. 

Diabetes mellitus occurs when the human body does not produce enough insulin. This form of diabetes is called insulin-dependent diabetes mellitus (IDDM, or juvenile diabetes, or type I diabetes). IDDM is an autoimmune disease (see Exhibit 4.7) in which the j8 cells are targeted by the body s own immune system and progressively destroyed. Once destroyed, they are unable to produce insulin. 

When there is insufficient insulin to bind to receptors, the cells are starved because sugar cannot reach the interior to provide energy for vital biological processes. Patients with IDDM become unwell when this happens. They depend on insulin injection for survival. 

Two weeks after an episode of the flu, an 8-year-old boy with IDDM is brought to the emergency room in a coma. His breathing is rapid and deep, and his breath has a fiuity odor. His blood glucose is 36.5 mM (normal 4-8 mM). The physician administeis IV fluids, insulin, and potassium chloride. A rapid effect of insulin in this situation is to stimulate... 

A 54-year-old man with type I (IDDM) diabetes is referred to an ophthalmologist for evaluation of developing cataracts. Pre-appointment blood work was requested and the results are shown below ... 

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. 

Failure of the body to synthesize sufficient insulin results in the development of insulin dependent diabetes mellitus (IDDM). This is also known as type 1 diabetes or juvenile-onset diabetes (Box 8.1). 

IDDM is caused by T cell-mediated autoimmune destruction of the insulin-producing P-pancreatic islet cells in genetically predisposed individuals. This is probably due to the expression of a super antigen on the surface of the jS cells in such individuals, although the molecular detail of what extent factors trigger onset of the jS cell destruction remain to be elucidated. IDDM may, however, be controlled by parenteral administration of exogenous insulin preparations, usually by regular s.c. injection. 

Diabetes meUitus, the most common form of diabetes, is caused by the partial or complete absence of insulin-triggered biological responses. Two forms of diabetes melUtus exist insulin dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes melUtus (NIDDM). 

IDDM, also known as t5 pe I diabetes, normally occurs during childhood or teens. It is caused by an autoimmune-mediated destruction of the insulin-producing pancreatic B cells. It is thus characterized by the absence or near-absence of insulin in the blood, even at elevated blood glucose levels. 

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. 

Bingley P.J. and E.A.M. Gale (1989). Rising incidence of IDDM in Europe. Diabetes Care 12 289-295. 

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... 

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