{"id":8287,"date":"2021-01-07T13:41:26","date_gmt":"2021-01-07T13:41:26","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=8287"},"modified":"2025-05-13T20:12:15","modified_gmt":"2025-05-13T20:12:15","slug":"diabetes","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/diabetes\/","title":{"rendered":"Classification of Diabetes Mellitus"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Diabetes is a heterogeneous, complex metabolic disorder characterized by elevated blood glucose concentrations secondary to either resistance to the action of insulin, insufficient insulin secretion, or both. The most common classifications include Type 1 diabetes mellitus, Type 2 diabetes mellitus, gestational diabetes and other specific types.<!--more--><\/p>\n<p><strong>Classification of Diabetes Mellitus<\/strong><br \/>\nDiabetes can be classified into the following general categories:<\/p>\n<ol>\n<li>Type 1 diabetes (due to autoimmune \u03b2-cell destruction, usually leading to absolute insulin deficiency, including latent autoimmune diabetes of adulthood)<\/li>\n<li>Type 2 diabetes (due to a progressive loss of adequate \u03b2-cell insulin secretion frequently on the background of insulin resistance)<\/li>\n<li>Specific types of diabetes due to other causes, e.g., monogenic diabetes syndromes (such as neonatal diabetes and maturity-onset diabetes of the young), diseases of the exocrine pancreas (such as cystic fibrosis and pancreatitis), and drug- or chemical-induced diabetes (such as with glucocorticoid use, in the treatment of HIV\/AIDS, or after organ transplantation)<\/li>\n<li>Gestational diabetes mellitus (diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes prior to gestation)<\/li>\n<\/ol>\n<p>Type 1 diabetes and type 2 diabetes are heterogeneous diseases in which clinical presentation and disease progression may vary considerably. Classification is important for determining therapy, but some individuals cannot be clearly classified as having type 1 or type 2 diabetes at the time of diagnosis. Children with type 1 diabetes typically present with the hallmark symptoms of polyuria\/polydipsia, and approximately one-third present with <a href=\"https:\/\/medicalcriteria.com\/web\/diabetic-ketoacidosis-hyperosmolar\/\" target=\"_blank\" rel=\"noopener noreferrer\">diabetic ketoacidosis (DKA)<\/a>. The onset of type 1 diabetes may be more variable in adults; they may not present with the classic symptoms seen in children and may experience temporary remission from the need for insulin. Occasionally, patients with type 2 diabetes may present with DKA. The classification of diabetes type is not always straightforward at presentation and that misdiagnosis is common (e.g., adults with type 1 diabetes misdiagnosed as having type 2 diabetes; individuals with maturity-onset diabetes of the young [MODY] misdiagnosed as having type 1 diabetes, etc.). Although difficulties in distinguishing diabetes type may occur in all age-groups at onset, the diagnosis becomes more obvious over time in people with \u03b2-cell deficiency.<\/p>\n<p>In both type 1 and type 2 diabetes, various genetic and environmental factors can result in the progressive loss of \u03b2-cell mass and\/or function that manifests clinically as hyperglycemia. Once hyperglycemia occurs, patients with all forms of diabetes are at risk for developing the same chronic complications, although rates of progression may differ.<\/p>\n<p>There is debate as to whether slowly progressive autoimmune diabetes with an adult onset should be termed <a href=\"https:\/\/medicalcriteria.com\/web\/diablada\/\" target=\"_blank\" rel=\"noopener noreferrer\">latent autoimmune diabetes in adults (LADA)<\/a> or type 1 diabetes. The clinical priority is awareness that slow autoimmune \u03b2-cell destruction can occur in adults leading to a long duration of marginal insulin secretory capacity. For the purpose of this classification, all forms of diabetes mediated by autoimmune \u03b2-cell destruction are included under the rubric of type 1 diabetes. Use of the term LADA is common and acceptable in clinical practice and has the practical impact of heightening awareness of a population of adults likely to develop overt autoimmune \u03b2-cell destruction, thus accelerating insulin initiation prior to deterioration of glucose control or development of DKA.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes\u20142021. American Diabetes Association Diabetes Care Jan 2021, 44 (Supplement 1) S15-S33 <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33298413\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Hope SV, Wienand-Barnett S, Shepherd M, King SM, Fox C, Khunti K, Oram RA, Knight BA, Hattersley AT, Jones AG, Shields BM. Practical Classification Guidelines for Diabetes in patients treated with insulin: a cross-sectional study of the accuracy of diabetes diagnosis. Br J Gen Pract. 2016 May;66(646):e315-22. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27080317\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Jan 05, 2021.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[626],"tags":[166,167,211,212],"class_list":["post-8287","post","type-post","status-publish","format-standard","hentry","category-diabetes","tag-clasificacion","tag-classification","tag-diabetes","tag-mellitus"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/8287","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=8287"}],"version-history":[{"count":11,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/8287\/revisions"}],"predecessor-version":[{"id":10043,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/8287\/revisions\/10043"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=8287"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=8287"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=8287"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}