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Types of Diabetes
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           All diabetic patients are not same. Diabetes is a disorder of insulin malfunctioning or insulin under-production. There are a number of reasons for this disorder.


American Diabetic Association and World Health Organization have divided diabetes into following types:


Type 1 Diabetes:

            Type 1diabetes is caused by a serious damage to beta cells of Islet of Langerhans found in the pancreas. Some people are genetically more prone to develop this type of diabetes. They have a specific subtype of HLA gene on their chromosome no. 6. After an infection in the body, which could be caused by a bacteria or a virus, the immune system of the body is activated. This leads to the production of antibodies, which destroy the invading organism. At the same time these antibodies damage the beta cells, thinking them to be foreign cells as the immune system fails to recognize host cell. The presence of special type of HLA genes in the body and immune response which does not recognize own body cells and damages beta cells leads to this type of condition. People with specific subtype of HLA genes can get this type of diabetes once the immune system is activated following infection. So beta cells are innocent victims of an immune assault occurring in genetically prone people. Here, it is important to stress that all people with HLA genes subtype do not get type 1 diabetes. Type 1 diabetes is a result of  the combination of genetic predisposition and an environmental trigger.

            Nowadays it is possible to identify people with HLA subtype, which can help in determining people at high risk of getting Type 1 Diabetes. In this type of diabetes the production of insulin almost stops due to severe damage to beta cells and the patients develop acute symptoms of diabetes like rapid weight loss, weakness, ketones in urine, coma due to ketoacidosis. This type of diabetes is commonly found in children and young adults, although practically any age group can be affected. Before 1921(Pre-Insulin era) this type of diabetes meant sure death.

            Availability of insulin has changed the scenario and now people with Type 1 Diabetes can live a near normal life span.

Type 2 Diabetes:

            This type of diabetes generally begins with insulin resistance, where efficacy of insulin is reduced. Initially in such patients overproduction of insulin is found leading to a condition called Hyperinsulinemia. This high level of insulin compensates for insulin resistance and thus maintains blood glucose in normal range.

            With passage of time the beta cells get exhausted and insulin levels decline, thus blood glucose level  starts  rising leading to diabetes.

            In such patients the number of beta cells decreases after a few years leading to decreased production of insulin. Therefore it can be said that Type 2 Diabetes starts off as reduced efficacy in the working of insulin but later on there is decreased production of insulin as well.

            Of late this type of disorder has been increasing in young adults. Obesity, high fat food, lack of physical activity and increased mental stress give rise to insulin resistance and thus diabetes. The symptoms in Type 2 Diabetes are much less severe than Type 1 Diabetes. This is the reason why many patients of Type 2 Diabetes are unaware of their ailment until it takes a serious form. In our country more than 95% of the patients are Type 2 Diabetes. This type of diabetes is commonly associated with high blood pressure and cholesterol problems, as insulin resistance is responsible for rise in blood pressure and lipid disorders. 

Gestational Diabetes:

This type of diabetes occurs during pregnancy. The hormonal changes in pregnancy lead to insulin resistance leading to Gestational Diabetes.

This diabetes appears during 5th to 6th month of pregnancy. It is mostly temporary. It is commonly found in those females who are either overweight or have a family history of diabetes. This diabetes generally disappears after delivery, but such females are at a higher risk for developing diabetes in future life. All females with a history of Gestational Diabetes should avoid high calorie foods and should have a regular exercise regimen to keep their weight near ideal body weight so that the possibility of developing diabetes in future is minimized. 

Gestational Diabetes is different from Pre-Gestational Diabetes. If a female who is already diabetic and becomes pregnant then such a condition is called  Pre-Gestational Diabetes.

Other types of diabetes:

1.         Genetic defects in Beta cells.

2.         Defects in Insulin receptors.

3.         Disorders of Pancreas.

                        -           Pancreatitis

-           Cancer of Pancreas

-           Fibrocalcific Pancreatitis

-           Cystic Fibrosis etc.

4.         Hormonal disorders.

5.         Diabetes due to medicines or toxins.

6.         Diabetes due to viral infections

7.         Miscellaneous  causes

Recurrent inflammation (swelling) in pancreas leads to destruction of beta cells causing diabetes. Excess of alcohol intake is the commonest cause of pancreatitis.


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