Group classification of diabetes was revised to focus on underlying disease etiopathologies. This lead to four clinical classes (Standards of Medical Care in Diabetes 2013): Type 1 diabetes, Type 2 diabetes, gestational diabetes and other specific types of diabetes due to other cause.

Major types of diabetes are Type 1 and Type 2 affecting anyone at any age and they both require attention and follow up.


Type 1 Diabetes (5 to 10% of cases)

 Type 1 diabetes is characterized by autoimmune (the body attacks its own cells) destruction of beta cells responsible for the secretion of insulin in the pancreas. As a result, there is an absolute lack of insulin which leads to glucose remaining in the blood and the person needs exogenous insulin (administered in the form of a subcutaneous injection) for survival.

The exact causes remain unclear but some environmental risk factors such as infections are thought to trigger the onset of Type 1 diabetes.

The onset of the disease is generally within weeks and if not well treated, Type 1 diabetes can lead to a life-threatening condition called diabetic ketoacidosis and even coma in severe cases.

Management includes: insulin regimen, healthy eating habits including advanced carbohydrate counting, and regular physical activity. Medications may be needed depending on complications and progression of the disease.

Regular checkup with the doctor and dietitian is essential in diabetes management.

Type 2 Diabetes (90 to 95% of cases)

Type 2 diabetes is the most common form of diabetes, and results from a resistance to insulin, the hormone responsible for allowing the body's cell to absorb glucose to use as energy, resulting in elevated glucose in the blood. In other cases, Type 2 diabetes develops from insufficient production of insulin and sometimes even a combination of both insufficient insulin production and resistance.

The increase in Type 2 diabetes can be due to the tremendous increase in obesity and the tendency toward a more sedentary lifestyle along with a strong genetic linkage.

Management includes: healthy eating habits and regular physical activity along with medications. Some people with Type 2 diabetes may require an insulin regimen as part of their treatment.

Regular checkup with the doctor and dietitian is essential in diabetes management.

Other specific types of diabetes due to other cause

Other less common types of diabetes can be caused by rare genetic defects, such as defects in beta cell function or in insulin action. In other cases, diabetes can result as a side effect of some other main disease, such as diseases of the exocrine pancreas (e.g. cystic fibrosis), or taking certain drugs or chemical medications.

Gestational Diabetes Mellitus (GDM)

Gestational Diabetes Mellitus (GDM) is diagnosed during pregnancy and is not clearly overt diabetes. GDM affects around 7% of pregnancies and in most cases disappears after delivery.
For some expectant mothers, the pancreas cannot keep up with the increased insulin needs during pregnancy leading to increase in blood glucose without apparent symptoms. Screening is usually done at 24-28 weeks of gestation.
Dietary changes and exercise may be enough to manage GDM, but medication is sometimes needed. If well managed, women with GDM go on to have healthy babies.


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