Classification of Diabetes: Type I, Type II, and... Does It Matter?

摘要

Diabetes mellitus (DM) is not a single disease, but a syndrome characterized by hyperglycemia that can be the result of defects in insulin secretion, insulin sensitivity (in target tissues), or both.1 There is a wide range of pathogenic processes thatcan lead to the development of DM, from autoimmune destruction of the b-cells of the pancreas with consequent insulin deficiency to abnormalities that result in resistance to insulin action. Regardless of the pathogenic cause, deficiency in insulin action on target tissues leads to a myriad of abnormalities in carbohydrate, fat, and protein metabolism. Abnormalities in insulin secretion and action frequently coexist in the same individual, and it is often unclear which abnormality, if either alone, isthe primary cause of the hyperglycemia. The degree of hyperglycemia (if any) may change over time, depending on the extent of the underlying disease process and comorbidities. A disease process may be present but may not have progressed far enough to cause hyperglycemia. The same disease process can cause prediabetes [impaired fasting glucose (IFG) and/ or impaired glucose tolerance 0GT)1 without fulfilline the criteria for the diagnosis of diabetes.