Diabetes mellitus type 1 Classification

Diabetes mellitus main page
Diabetes mellitus type 1 Microchapters
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Classification
Causes
Differentiating Diabetes mellitus type 1 from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural history, Complications, and Prognosis
Diagnosis
Diagnostic study of choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Dietary Management
Medical Therapy
Surgery
Strategies for Improving Care
Foundations of Care and Comprehensive Medical Evaluation Diabetes Self-Management, Education, and Support Nutritional Therapy
Glycemic Targets
Approaches to Glycemic Treatment
Cardiovascular Disease and Risk Management Hypertension and Blood Pressure Control Lipid Management Antiplatelet Agents Coronary Heart Disease
Microvascular Complications and Foot Care Diabetic Kidney Disease Diabetic Retinopathy Diabetic Neuropathy Diabetic Footcare
Older Adults with Diabetes
Children and Adolescents with Diabetes Management of Cardiovascular Risk Factors in Children and Adolescents with Diabetes Microvascular Complications in Children and Adolescents with Diabetes
Management of Diabetes in Pregnancy
Diabetes Care in the Hospital Setting
Primary Prevention
Future or Investigational Therapies
Case Studies
Case #1

Diabetes mellitus Main page
Patient Information Type 1 Type 2
Overview
Classification Diabetes mellitus type 1 Diabetes mellitus type 2 Gestational diabetes
Differential Diagnosis
Complications
Screening
Diagnosis
Prevention

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:
  • Immune-mediated
  • Idiopathic
• Based on clinical presentation, Type 1 DM can be classified into:
  • 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:
  • 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.