Diabetes mellitus type 1 Classification: Difference between revisions
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{{Diabetes mellitus type 1}} | {{Diabetes mellitus type 1}} | ||
{{Diabetes mellitus}} | {{Diabetes mellitus}} | ||
{{CMG}} | {{CMG}}{{AE}}{{VD}}{{Anahita}} | ||
==Overview== | ==Overview== | ||
American Diabetic Association(ADA), | According to American Diabetic Association (ADA), [[type 1 DM]] could be classified based on both [[etiology]] and clinical presentations. Based on [[etiology]] [[type 1 DM]] can be classified into immune mediated or [[idiopathic]]. Nevertheless classic new onset [[diabetes mellitus]] and [[Diabetic ketoacidosis]] are considered two classes of [[diabetes mellitus type 1]] based on clinical presentations. | ||
==Classification== | ==Classification== | ||
Based on etiology, American diabetic association has classified type 1 DM into:<ref>{{Cite web|url=http://care.diabetesjournals.org/content/38/Supplement_1/S8|title=|last=|first=|date=|website=|publisher=|access-date=}}</ref> | * Based on [[etiology]], American diabetic association has classified [[type 1 DM]] into:<ref>{{Cite web|url=http://care.diabetesjournals.org/content/38/Supplement_1/S8|title=|last=|first=|date=|website=|publisher=|access-date=}}</ref> | ||
* Immune-mediated | ** Immune-mediated | ||
* Idiopathic | ** [[Idiopathic]] | ||
Based on | * Based on clinical presentation, [[Type 1 DM]] can be classified into:<ref>Type 1 Diabetes mellitus "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 27th,2016</ref> | ||
* Classic new onset | ** Classic new onset [[diabetes mellitus]] | ||
* Diabetic ketoacidosis | ** [[Diabetic ketoacidosis]] | ||
* Some studies proposed a new subtype of [[diabetes mellitus type 1]]. The following are some features of this subtype:<ref name="ImagawaHanafusa2000">{{cite journal|last1=Imagawa|first1=Akihisa|last2=Hanafusa|first2=Toshiaki|last3=Miyagawa|first3=Jun-ichiro|last4=Matsuzawa|first4=Yuji|title=A Novel Subtype of Type 1 Diabetes Mellitus Characterized by a Rapid Onset and an Absence of Diabetes-Related Antibodies|journal=New England Journal of Medicine|volume=342|issue=5|year=2000|pages=301–307|issn=0028-4793|doi=10.1056/NEJM200002033420501}}</ref><ref name="pmid8285838">{{cite journal| author=Kimura N, Fujiya H, Yamaguchi K, Takahashi T, Nagura H| title=Vanished islets with pancreatitis in acute-onset insulin-dependent diabetes mellitus in an adult. | journal=Arch Pathol Lab Med | year= 1994 | volume= 118 | issue= 1 | pages= 84-8 | pmid=8285838 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8285838 }} </ref> | |||
** There is no relationship to [[autoimmune disease|autoimmune conditions]], evidenced by absence of any [[diabetes mellitus type 1]] related [[autoantibody|autoantibodies]], such as [[Glutamate decarboxylase]], [[Islets of Langerhans|islet-cell]], IA-2, or [[insulin]] [[antibody|antibodies]]. | |||
** [[pancreas|Pancreatic]] [[biopsy|biopsies]] revealed neither insulitis nor hyperexpression of [[MHC class I]] [[Molecule|molecules]] as it is expected in [[diabetes mellitus type 1]]. In the contrary [[lymphocyte|lymphocytic]] infiltrates were reported in the [[Exocrine gland|exocrine]] [[pancreas]]. | |||
** With a rapid onset, only few days after hyperglycemic symptoms (mean duration of four days) [[patient|patients]] were diagnosed with [[diabetic ketoacidosis]]. The short period of [[hyperglycemia]] is evidenced by normal [[Glycosylated hemoglobin|HbA1C]] in these [[patient|patients]]. | |||
** The study demonstrated that this group has low [[insulin]] [[secretion]], which is further supported by a low [[C-peptide]] urinary excretion. | |||
** In contrast to other [[diabetes mellitus type 1]] [[patient|patients]] with normal [[serum]] [[pancreas|pancreatic]] [[enzyme]] [[concentration|concentrations]] and evidences of insulinitis, this subtype is presented with noticeably elevated [[pancreas|pancreatic]] [[enzyme]] level and [[lymphocyte|lymphocytic]] infiltrates in the [[Exocrine gland|exocrine]] [[pancreas]]. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
Latest revision as of 18:05, 6 September 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]Anahita Deylamsalehi, M.D.[3]
Overview
According to American Diabetic Association (ADA), type 1 DM could be classified based on both etiology and clinical presentations. Based on etiology type 1 DM can be classified into immune mediated or idiopathic. Nevertheless classic new onset diabetes mellitus and Diabetic ketoacidosis are considered two classes of diabetes mellitus type 1 based on clinical presentations.
Classification
- Based on etiology, American diabetic association has classified type 1 DM into:[1]
- Immune-mediated
- Idiopathic
- Based on clinical presentation, Type 1 DM can be classified into:[2]
- Classic new onset diabetes mellitus
- Diabetic ketoacidosis
- Some studies proposed a new subtype of diabetes mellitus type 1. The following are some features of this subtype:[3][4]
- There is no relationship to autoimmune conditions, evidenced by absence of any diabetes mellitus type 1 related autoantibodies, such as Glutamate decarboxylase, islet-cell, IA-2, or insulin antibodies.
- Pancreatic biopsies revealed neither insulitis nor hyperexpression of MHC class I molecules as it is expected in diabetes mellitus type 1. In the contrary lymphocytic infiltrates were reported in the exocrine pancreas.
- With a rapid onset, only few days after hyperglycemic symptoms (mean duration of four days) patients were diagnosed with diabetic ketoacidosis. The short period of hyperglycemia is evidenced by normal HbA1C in these patients.
- The study demonstrated that this group has low insulin secretion, which is further supported by a low C-peptide urinary excretion.
- In contrast to other diabetes mellitus type 1 patients with normal serum pancreatic enzyme concentrations and evidences of insulinitis, this subtype is presented with noticeably elevated pancreatic enzyme level and lymphocytic infiltrates in the exocrine pancreas.
References
- ↑ http://care.diabetesjournals.org/content/38/Supplement_1/S8. Missing or empty
|title=(help) - ↑ Type 1 Diabetes mellitus "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 27th,2016
- ↑ Imagawa, Akihisa; Hanafusa, Toshiaki; Miyagawa, Jun-ichiro; Matsuzawa, Yuji (2000). "A Novel Subtype of Type 1 Diabetes Mellitus Characterized by a Rapid Onset and an Absence of Diabetes-Related Antibodies". New England Journal of Medicine. 342 (5): 301–307. doi:10.1056/NEJM200002033420501. ISSN 0028-4793.
- ↑ Kimura N, Fujiya H, Yamaguchi K, Takahashi T, Nagura H (1994). "Vanished islets with pancreatitis in acute-onset insulin-dependent diabetes mellitus in an adult". Arch Pathol Lab Med. 118 (1): 84–8. PMID 8285838.