Diabetes Mellitus

"Diabetes" redirects here. For the journal, see Diabetes (journal). See also
Diabetes insipidus.
Diabetes mellitus
Classification and external resources

Universal blue circle symbol for diabetes.[1]

ICD-10 E10.E14.
ICD-9 250
MedlinePlus 001214
eMedicine med/546 emerg/134
MeSH C18.452.394.750

Diabetes mellitus, often simply referred to as diabetesis a group of

metabolic diseases in which a person has high blood sugar, either
because the body does not produce enough insulin, or because cells do
not respond to the insulin that is produced. This high blood sugar
produces the classical symptoms of polyuria (frequent urination),
polydipsia (increased thirst) and polyphagia (increased hunger).

There are three main types of diabetes:

Type 1 diabetes: results from the body's failure to produce insulin,

and presently requires the person to inject insulin. (Also referred to
as insulin-dependent diabetes mellitus, IDDM for short, and juvenile
diabetes.)

Type 2 diabetes: results from insulin resistance, a condition in which

cells fail to use insulin properly, sometimes combined with an
absolute insulin deficiency. (Formerly referred to as non-insulin-
dependent diabetes mellitus, NIDDM for short, and adult-onset
diabetes.)
 Gestational diabetes: is when pregnant women, who have never had
diabetes before, have a high blood glucose level during pregnancy.
It may precede development of type 2 DM.

Other forms of diabetes mellitus include congenital diabetes, which is due

to genetic defects of insulin secretion, cystic fibrosis-related diabetes,
steroid diabetes induced by high doses of glucocorticoids, and several
forms of monogenic diabetes.

All forms of diabetes have been treatable since insulin became available
in 1921, and type 2 diabetes may be controlled with medications. Both
type 1 and 2 are chronic conditions that usually cannot be cured. Pancreas
transplants have been tried with limited success in type 1 DM; gastric
bypass surgery has been successful in many with morbid obesity and
type 2 DM. Gestational diabetes usually resolves after delivery. Diabetes
without proper treatments can cause many complications. Acute
complications include hypoglycemia, diabetic ketoacidosis, or nonketotic
hyperosmolar coma. Serious long-term complications include
cardiovascular disease, chronic renal failure, retinal damage. Adequate
treatment of diabetes is thus important, as well as blood pressure control
and lifestyle factors such as smoking cessation and maintaining a healthy
body weight.
Comparison of type 1 and 2 diabetes
Feature Type 1 diabetes Type 2 diabetes
Onset Sudden[4] Gradual[4]
Any age
Age at onset Mostly in adults
(mostly young)[4]
Body habitus Thin[4] or normal[5] Often obese[4]
[4]
Ketoacidosis Common Rare[4]
Autoantibodies Usually present[4] Absent[4]
Normal, decreased
Endogenous insulin Low or absent[4]
or increased[4]
Concordance
50%[4] 90%[4]
in identical twins
More prevalent
Prevalence Less prevalent - 90 to 95% of
U.S. diabetics[6]
As of 2000 at least 171 million people worldwide suffer from diabetes, or
2.8% of the population.[2] Type 2 diabetes is by far the most common,
affecting 90 to 95% of the U.S. diabetes population.

Most cases of diabetes mellitus fall into three broad categories: type 1,
type 2, and gestational diabetes. A few other types are described.

Type 1 diabetes

Main article: Diabetes mellitus type 1

Type 1 diabetes mellitus is characterized by loss of the insulin-producing
beta cells of the islets of Langerhans in the pancreas leading to insulin
deficiency. This type of diabetes can be further classified as immune-
mediated or idiopathic. The majority of type 1 diabetes is of the immune-
mediated nature, where beta cell loss is a T-cell mediated autoimmune
attack.[7] There is no known preventive measure against type 1 diabetes,
which causes approximately 10% of diabetes mellitus cases in North
America and Europe. Most affected people are otherwise healthy and of a
healthy weight when onset occurs. Sensitivity and responsiveness to
insulin are usually normal, especially in the early stages. Type 1 diabetes
can affect children or adults but was traditionally termed "juvenile
diabetes" because it represents a majority of the diabetes cases in
children.

Type 2 diabetes

Main article: Diabetes mellitus type 2

Type 2 diabetes mellitus is characterized by insulin resistance which may

be combined with relatively reduced insulin secretion. The defective
responsiveness of body tissues to insulin is believed to involve the insulin
receptor. However, the specific defects are not known. Diabetes mellitus
due to a known defect are classified separately. Type 2 diabetes is the
most common type.

In the early stage of type 2 diabetes, the predominant abnormality is

reduced insulin sensitivity. At this stage hyperglycemia can be reversed by
a variety of measures and medications that improve insulin sensitivity or
reduce glucose production by the liver.

Gestational diabetes

Main article: Gestational diabetes

Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several

respects, involving a combination of relatively inadequate insulin secretion
and responsiveness. It occurs in about 2%5% of all pregnancies and may
improve or disappear after delivery. Gestational diabetes is fully treatable
but requires careful medical supervision throughout the pregnancy. About
20%50% of affected women develop type 2 diabetes later in life.

Even though it may be transient, untreated gestational diabetes can

damage the health of the fetus or mother. Risks to the baby include
macrosomia (high birth weight), congenital cardiac and central nervous
system anomalies, and skeletal muscle malformations. Increased fetal
insulin may inhibit fetal surfactant production and cause respiratory
distress syndrome. Hyperbilirubinemia may result from red blood cell
destruction. In severe cases, perinatal death may occur, most commonly
as a result of poor placental perfusion due to vascular impairment. Labor
induction may be indicated with decreased placental function. A cesarean
section may be performed if there is marked fetal distress or an increased
risk of injury associated with macrosomia, such as shoulder dystocia.

A 2008 study completed in the U.S. found that the number of American
women entering pregnancy with preexisting diabetes is increasing. In fact
the rate of diabetes in expectant mothers has more than doubled in the
past 6 years.[8] This is particularly problematic as diabetes raises the risk
of complications during pregnancy, as well as increasing the potential that
the children of diabetic mothers will also become diabetic in the future.

Other types

Pre-diabetes indicates a condition that occurs when a person's blood

glucose levels are higher than normal but not high enough for a diagnosis
of type 2 diabetes. Many people destined to develop type 2 diabetes
spend many years in a state of pre-diabetes which has been termed
"America's largest healthcare epidemic."[9]:1011

Latent autoimmune diabetes of adults is a condition in which Type 1

diabetes develops in adults. Adults with LADA are frequently initially
misdiagnosed as having Type 2 diabetes, based on age rather than
etiology.

Some cases of diabetes are caused by the body's tissue receptors not
responding to insulin (even when insulin levels are normal, which is what
separates it from type 2 diabetes); this form is very uncommon. Genetic
mutations (autosomal or mitochondrial) can lead to defects in beta cell
function. Abnormal insulin action may also have been genetically
determined in some cases. Any disease that causes extensive damage to
the pancreas may lead to diabetes (for example, chronic pancreatitis and
cystic fibrosis). Diseases associated with excessive secretion of insulin-
antagonistic hormones can cause diabetes (which is typically resolved
once the hormone excess is removed). Many drugs impair insulin
secretion and some toxins damage pancreatic beta cells. The ICD-10
(1992) diagnostic entity, malnutrition-related diabetes mellitus (MRDM or
MMDM, ICD-10 code E12), was deprecated by the World Health
Organization when the current taxonomy was introduced in 1999.[10]

Translate..

Diabetes mellitus, sering disebut sebagai diabetes- adalah sekelompok

penyakit metabolik di mana seseorang yang memiliki kadar gula darah
tinggi, baik karena tubuh tidak memproduksi insulin yang cukup, atau
karena sel tidak merespon insulin yang dihasilkan. Gula darah tinggi ini
menghasilkan gejala klasik poliuri (sering kencing), polidipsia (haus
meningkat) dan polyphagia (kelaparan meningkat).
Ada tiga jenis utama diabetes:

* Tipe 1 diabetes: hasil dari kegagalan tubuh untuk memproduksi

insulin, dan saat ini mengharuskan orang untuk menyuntikkan insulin.
(Juga disebut sebagai diabetes mellitus tergantung insulin, IDDM untuk
jangka pendek, dan diabetes anak-anak.)
* Tipe 2 diabetes: hasil dari resistensi insulin, suatu kondisi di mana sel-
sel gagal untuk menggunakan insulin dengan benar, kadang
dikombinasikan dengan kekurangan insulin absolut. (Dahulu disebut
diabetes mellitus non-insulin-dependent, NIDDM untuk jangka pendek,
dan dewasa-onset diabetes.)
* Gestational diabetes: adalah ketika ibu hamil, yang belum pernah
menderita diabetes sebelumnya, memiliki kadar gula darah tinggi selama
kehamilan. Ini mungkin mendahului pengembangan tipe 2 DM.

Bentuk-bentuk lain diabetes mellitus termasuk diabetes bawaan, yang

karena cacat genetik sekresi insulin, diabetes cystic fibrosis terkait,
diabetes steroid disebabkan oleh glukokortikoid dosis tinggi, dan beberapa
bentuk diabetes monogenik.

Semua bentuk diabetes telah diobati sejak insulin menjadi tersedia pada
tahun 1921, dan diabetes tipe 2 dapat dikendalikan dengan obat. Kedua
tipe 1 dan 2 adalah kondisi kronis yang biasanya tidak dapat
disembuhkan. Transplantasi pankreas telah dicoba dengan sukses
terbatas dalam tipe 1 DM; operasi bypass lambung telah berhasil dalam
banyak dengan obesitas morbid dan tipe 2 DM. Diabetes kehamilan
biasanya sembuh setelah melahirkan. Diabetes tanpa perawatan yang
tepat dapat menyebabkan komplikasi banyak. komplikasi akut mencakup
hipoglikemia, ketoasidosis diabetes, atau koma hiperosmolar nonketotic.
komplikasi jangka panjang yang serius termasuk penyakit jantung, gagal
ginjal kronis, kerusakan retina. perawatan yang memadai diabetes
demikian penting, dan juga sebagai kontrol tekanan darah dan faktor gaya
hidup seperti berhenti merokok dan menjaga berat badan yang sehat.

Pada tahun 2000 setidaknya 171 juta orang di seluruh dunia menderita
diabetes, atau 2,8% dari populasi. [2] diabetes tipe 2 adalah yang paling
umum, yang mempengaruhi 90 hingga 95% dari populasi diabetes AS