Download Diabetes Mellitus - Pathology Dept.

Diabetes Mellitus
Classification & Pathogenesis
Dr. SaminaRizvi
Associate Professor
Pathology
JSMU
Objectives of Lecture
1.Present an overview of the common forms of Diabetes Mellitus
2.Review the pathogenesis of each
3.Describe the risk factors for developing each
Definition of Diabetes Mellitus
A chronic disorder of carbohydrate & fat metabolism….. due to absolute/or relative deficiency in insulin
secretion……. &/or ineffective biological responses to insulin….. resulting in hyperglycemia
To maintain a constant blood glucose level, the body relies on two hormones produced in the pancreas
that have opposite actions: insulin and glucagon.
Classification of DiabetesMellitus
PRIMARY DIABETES MELLITUS
TYPE I DIABETES MELLITUS or Juvenile Onset diabetes
TYPE II DIABETES MELLITUS or Adult Onset diabetes
Two Major Forms of DM
Type 1 Diabetes (T1DM)
-Absolute insulin deficiency resulting from beta-cell destruction….. usually caused by an
autoimmune process and these patients are prone to ketoacidosis.
Type 2 Diabetes (T2DM)
-Biological ineffectiveness of insulin action (Insulin resistance) and/or beta cell secretory
defects…..a major factor is thought to be acquisition of visceral obesity in genetically susceptible
individuals
Types of Diabetes
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Gestational Diabetes
Other types:
LADA (Latent Autoimmune Diabetes of Adulthood
MODY (maturity-onset diabetes of youth)
Secondary Diabetes Mellitus
Gestational diabetes mellitus (GDM)
SECONDARY DIABETES MELLITUS
Drug induced hyperglycemia
MODY
Maturity –onset diabetes of the young (MODY) is a subgroup due to monogenic disorder characterized
by non-insulin –dependent diabetes with autosomal dominant inheritance and an age at onset of 25
years or younger.
Diagnosis confirmed by genetic testing.
LADA
Latent Autoimmune Diabetes in Adults (LADA) is a form of autoimmune (type 1 diabetes) which is
diagnosed in individuals who are older than the usual age of onset of type 1 diabetes.
Type 1 Diabetes Mellitus (T1DM)
-Pattern A: autoimmune process
-Pattern B: unknown cause (viral?)
Pathogenesis of Type 1 diabetes.
Implicated viruses:
Clinical features of Type 1 diabetes.
Pathogenesis of T2DM
Risk Factors for T2DM
1.
2.
3.
4.
5.
Family history/genetics
Western life-style
Tobacco us
Lack of exercise
Hypertension & Hyperlipidemia
Laboratory findings
Urinary analysis
Blood test procedures
B cell Reserve Evaluation
Autoantibodies
Lipoprotein Abormalities in Diabetes
Blood test procedures
A. Glucose Tolerance Test
B. Glycated Hemoglobin (Hemoglobin A1) measurements
C. Serum Fructosamine
D. Self –Monitoring of Blood Glucose