Question

Evie’s Mother is a health professional and asks you what the difference is between Type I and Type II diabetes. Outline your response to Evie’s Mother, at a level appropriate to another health professional.

Answer 1

Difference between Type I and Type II disbetes mellitus.

-Type I diabetes also known as insulin dependent diabetes mellitus.It usually acute in onset and occur before 30 years of age.It occurs as a result of distraction of pancreatic beta cells.The major etiolical factors are genetic ,immunologic and possibly environmental (viral agents and toxins). Individuals with certain HLA types are more susceptible to Type I DM.Autoimmune responses also have major contribution in the development Type I DM..Autoantibodies are develprd against the islet cells in pancreas and endogenous insulin.This results in beta cell destruction and thus decreased amount of insulin.,unchecked glucose production by liver and fasting hyperglycemia.Also glucose remains in blood stream instead of storing in liver,leading to post prandial hyperglycemia. Glunoneogenesis Ang glycogenolysis will be triggered due to absence of insulin.It also contributes to marked hyperglycemia.If it exeeds above renal threshold (180-200mg/) glucosuria occurs doe to lack of reabsorption.It also promotes osmotic diuresis.

Type I DM can only be managed with insulin therapy.Frequent monitoring of blood sugar is essential to manage insulin dosage and to prevent hypoglycemia.

Common complications include hyperglycemia and diabetic ketoacidosis.

Type II DM also known as non-insulin dependent DM.It occurs due to insulin resistance that is decreased tissue sensitivity to insulin and impaired/decreased insulin secretion.The main etiological factors are obesity,heredity,increased consumption of glucose containing substances,long term use of certain drugs like corticosteroids.Onset is Slow and progressive.Here the available insulin insufficient to maintain euglycemia.So increased amount of insulin is to be produced leading to metabolic syndrome.Type II DM can be managed with oral hypoglycemic agents ,dietarydietary restrictions and exercises.Some patients may require short term or long term use of insulin to maintain euglycemia.Ketosis is uncommon.Common complications include hyperglycemia hyper osmolar syndrome and other microvascular complications like retinopathy,nephropathy, neuropathy.