Diabetes Mellitus and its types
Diabetes Mellitus (DM) is a common and potentially serious, chronic metabolic condition which is characterized predominantly by hyperglycemia and other manifestations. Diabetes can be a devastating condition with long-lasting hazardous consequences since due to its chronicity it affects almost all the major organs of the body including the eyes, the kidneys, the nerves, heart and blood vessels (Jennifer, 1998). DM was classified into two major subtypes viz. Insulin Dependent Diabetes Mellitus (IDDM) and Non-Insulin Dependent Diabetes Mellitus (NIDDM) in 1979 by the National Diabetes Data Group and this classification was later endorsed by WHO (Jennifer, 1998). However, this classification had certain limitations and therefore the recent guidelines classify DM into four main groups viz. type 1 DM, type 2 DM, “other specific types” and gestational diabetes (Jennifer, 1998).
Type 1 DM (TID) is a condition that typically manifests itself in early childhood and is characterized by an autoimmune destruction of beta cells located in the pancreatic islets (Zipris, 2009). It is estimated that this subtype of DM afflicts almost one million individuals in the United States alone (Notkins, 2002). The development of Type 1 DM has been shown to be genetically determined and several HLA alleles have found to be implicated in the causation of this disorder (Redondo, Fain and Eisenbarth, n.d.).
However, more recently, due to the rapid increase in the incidence of TID, it has been postulated that in addition to genetic susceptibility, environmental factors also contribute towards the development of TID (Zipris, 2009). These include factors such as diet, advanced maternal age and viral infections amongst others (Zipris, 2009). Moreover, the role of triggers such as certain proteins in cow’s milk has been postulated and is under research (Nucci, Horn, Becker, Virtanen, & Akerblom, n.d.). On the other hand, Type 2 DM, which affects more than 16 million people in the United States (Notkins 43545) is heterogeneous in nature in that it results from an interplay between genetics and environmental factors. Diabetes Mellitus has several potentially serious complications including blindness, amputations, and end-stage renal disease (Kantárová and Buc 255).