Normal and Therapeutic Nutrition

Normal and Therapeutic Nutrition 3(2+1)

Lesson 29:Diabetes – causes, symptoms

Classification

Type I diabetes mellitus (IDDM)

• Type I diabetes affects children or adults, was traditionally termed “Juvenile diabetes” (Figure)


• Occurs due to loss of insulin-producing ?-cells of the islets of Langerhans in the pancreas, leading to a deficiency of insulin (Figure)


• Immune-mediated or idiopathic. The majority of type I diabetes is of the immune-mediated variety, where beta cell loss is a T-cell mediated autoimmune attack.
• Most affected people are otherwise healthy with weight during onset of diabetes.
• Sensitivity and responsiveness to insulin are usually normal in the early stages
• Later the child becomes underweight and develops acidosis

Type II diabetes mellitus (NIDDM)

• Adult onset diabetes occurs due to obesity
• Milder or more stable
• Caused due to insulin resistance or reduced insulin sensitivity
• Due to reduced insulin secretion
• The defective responsiveness of body tissues to insulin by the insulin receptor in cell membranes (Figure)

Malnutrition Related Diabetes Mellitus (MRDM)

• Seen in young people (15-30 yrs) of tropical countries
• Pancreas fail to produce adequate amount of insulin
• Do not develop ketoacidosis

Gestational diabetes

• Gestational diabetes mellitus (GDM) resembles Type II diabetes, involving a combination of relatively inadequate insulin secretion and responsiveness
• It occurs in about 2-5% of all pregnancies and may improve or disappear after delivery.
• Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy
• About 20-50% of affected women develop type II diabetes later in life.
• They give birth to large babies. (Figure)