Diabetes Overview

Diabetes affects about 21 million people in the US, attributed to overweight, sedentary lifestyle, and increased elderly population in which most cases occur.

Caused by relative or absolute insulin deficiency.

Also known as "starvation in a sea of food," as glucose is present, but due to a lack of insulin or insulin resistance, the nutrition (carbohydrate, fat, and protein) is not getting to the cells.

Type 1 diabetes (Insulin-dependent Diabetes Mellitus)

5-10% of diabetics are caused by autoimmune destruction of B-cells of the pancreatic islets.

May also have Thyroid or Addison Disease (glucocorticoid/mineralocorticoid deficiency = no cortisol (required for normal glucose), no aldosterone)

Age of onset usually <30 yrs

Usually, there is no pancreatic function (symptoms appear when 80% of B-cells are destroyed)

No strong family history

Obesity uncommon

Treated with insulin, diet, exercise

Type 2 diabetes mellitus

90% of diabetics

• Impaired insulin secretion, insulin resistance, and excessive hepatic glucose production.
• Produces insufficient insulin to maintain normal glucose levels

Usually >40 yrs

Insulin present in low to normal amounts, lower over time

Strong family history

Obesity is common (increased adipose tissue = increased insulin resistance)

Oral hypoglycemic agents, diet, exercise