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Mellitus

Also Known As:  Diabetes mellitusBlood SugarBlood GlucoseGlucose

Related Diaseases: Kidney DiseasesPancreatic DiseasesHeart DiseaseHeart AttackStrokeMetabolic SyndromeAcidosis and AlkalosisNeuropathyPregnancy

Definition of diabetes mellitus:

  • Diabetes mellitus is a group of metabolic disorders of carbohydrates metabolism in which glucose is not properly utilized, leading to hyperglycemia.
  • Criteria for the diagnosis of diabetes Mellitus:
    • Polyuria, polydipsia and rapid weight loss.
    • Insulinopenia decreased insulin due to the loss of β-cells of the pancreas.
    • Most patients have autoantibody were called an autoimmune process.
    • While no cause known is called idiopathic type.

Type of Diabetes  Mellitus:

  1. Type 1 diabetes mellitus is insulin-dependent/ juvenile-onset and its types are:
    • Autoimmune type.
    • Idiopathic type.
  2. Type 2 diabetes mellitus is non-insulin dependent or adult on set type.
    • Patients have minimal symptoms.
    • This is not dependent on insulin to prevent ketonuria.
    • The insulin level may be normal or decreased or increased.
    • Most patients have impaired insulin action.
  3. Gestational diabetes mellitus.
    • This is first diagnosed during pregnancy.
    • Already known cases of diabetic women are not included in this group.
    • This occurs in 6 to 8% of the pregnant ladies.
    • These ladies are at increased risk later on to develop diabetes mellitus (6 to 62% of these ladies).
  4. Impaired glucose tolerance (IGT).
    • This group has less fasting glucose than required for diabetes mellitus.
    • An oral glucose tolerance test is needed to diagnose this group.
    • The overt case develops 1 to 5% per year.
    • Microvascular diseases are very uncommon in this group.
  5. Impaired fasting glucose (IFG).
    • This is diagnosed by fasting glucose values between normal and diabetics individuals.
    • This is a metabolic stage between normal glucose and diabetes mellitus.
    • There is an increased risk for the development of diabetes and cardiovascular disease.

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Latest classification criteria for diabetes mellitus

  1. Diabetes mellitus:
    1. Presence of classical symptoms.
    2. If fasting glucose level 126 mg/dl (>7.0 mmol/L) or above should be labeled as D. Mellitus (when this value is found two times).
    3. One random glucose level of more >200 mg/dl  (11.1 mmol/L) with symptoms of polyuria, polydipsia, and polyphagia are considered diagnostic of diabetes.
    4. HbA1c more than 6.5 % diagnostic for Diabetes.
    5. The 2-hour postprandial glucose level of  ≥200 mg/dl  (11.1 mmol/L) during OGTT.
  2. Impaired fasting glucose = > 126 mg/dl. (fasting glucose level 110 to 125 mg/dL (6.1 to 7.0 mmol/L).
  3. Impaired glucose tolerance when:
    1. Fasting glucose < 126 mg/dl (7 mmol/L).
    2. OGTT 2 hours sample is 140 mg to 199 mg/dl (7.8 to 11.1 mmol/L).

Criteria for the diagnosis of diabetes mellitus

  • Fasting blood glucose level:
    • 126 mg/dL (7.0 mmol/L) or higher is considered diagnostic.
  • Random/ non fasting blood glucose level:
    • 200 mg/dL (11.1 mmol/L) is diagnostic.
  • Oral glucose tolerance test with 75 G of glucose:
    • 2-hour sample 200 mg/dL  (11.1 mmol/L) or higher value is diagnostic.



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