DM is a syndrome characterized by alterations in the metabolism of carbohydrates, fats and proteins with a heterogeneous and multifactorial etiological mechanism that has not yet been fully elucidated. It is attributed to the lack of insulin (absolute or relative) or the presence of factors that block the action of insulin. Diabetes, known since ancient times, remains a global health problem with a large participation in the occurrence of cardiovascular disease, blindness, kidney failure and lower limb amputations. According to the World Health Organization (WHO) classification, the clinical forms of DM are classified into the following categories.
Etiological Classification Diabetes Mellitus *
A) Type 1 (Insulin-dependent DM – IDDM -)
- (β-cell destruction leading to complete insulin deficiency)
- autoimmune
- idiopathic
B) Type 2 (non-insulin-dependent DM – NIDDM -)
- (range extending from predominant insulin resistance and mild insulin deficiency to predominant insulin deficiency and mild resistance)
C) Other special types
1.Genetic β-cell lesions – chromosome 12. HNF-1a (MODY 3), chromosome 7. glucokinase (MODY 2), chromosome 20. HNF-4a (MODY 1), mitochondrial DNA
2. Genetic damage to insulin action (type A insulin resistance, leprechaunism. lipoatrophic diabetes)
3. Diseases of the exocrine portion of the pancreas (pancreatitis, trauma/pancreatectomy, neoplasia)
4. Endocrine diseases (acromegaly, Cushing syndrome, glucagonoma, somatostatinoma, pheochromocytoma)
5. Medicinal substances (glucocorticoids, thiazides, β-adrenergic antagonists, diazoxide, thyroid hormones, nicotinic acid)
6. Certain genetic syndromes
D) Gestational Diabetes Mellitus
* This classification does not include impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) which are considered pre-diabetic conditions and do not necessarily progress to diabetes mellitus.
Regarding this classification most frequent and appearing greater clinical significance are type 1 DM (Insulin dependent), type 2 DM (non-insulin dependent) and gestational diabetes Other terms such as mild, severe diabetes, etc., are meaningless and should not be used because they distract from the final goal, which is to prevent the occurrence of complications, which occur not only in long-term and poorly regulated diabetics but also to those who need no other treatment than diet.
GRADUATE COURSES IN ENDOCRINOLOGY AND DIABETES- DEPARTMENT OF ENDOCRINOLOGY DIABETES AND METABOLISM OF EVANGELISMOS GENERAL HOSPITAL OF ATHENS- 2004
