Types of Diabetes 
Several types of diabetes mellitus (diabetes mellitus) have been identified till date and the latest classification has been given by the World Health Organization (WHO). According to this classification, there are three main divisions:
(1) diabetes mellitus,
(2) glucose-impaired regulation, and
(3) gestational diabetes.
The first and largest section is Diabetes Mellitus – the second is divided into four sub-sections.
1. Insulin-dependent diabetes (type-1)
2. Insulin-non-dependent diabetes (type-2)
3. Diabetes associated with malnutrition and
4. Diabetes due to other causes.
Most diabetic patients in developed countries are either type-1 or type-2 diabetes. About 20% of patients have type-1 and 80% of patients have type-2 diabetes. In addition to these two types, a third type, known as malnutrition-related diabetes, has been found in developing and underdeveloped poor countries. However, the relationship between malnutrition and diabetes is not yet known with certainty. More research is going on about malnutrition and more information about it after a few years can be found. According to the latest revisions suggested by the American Diabetes Association, malnutrition-related diabetes should be removed from the main subcategory. For now, we will limit our discussion to type-1 and type-2 diabetes.
Type-1 diabetes is called insulin-dependent diabetes.
Because insulin production in these patients is so reduced (or production has stopped) that the lack of insulin can lead to serious (sometimes fatal) complications such as ketoacidosis and necessitates external insulin injections. becomes Usually, this type of diabetes starts in childhood. For the sake of simplicity, type-1 diabetes is referred to as childhood diabetes.
Type-2 or non-insulin-dependent diabetes patients have a relative lack of insulin,
meaning that the patient's body produces the same amount of insulin, but the need for insulin increases in the second half of the day. (Most patients are overweight). Usually in adulthood, after forty years, this type of diabetes occurs, which for the sake of simplicity we will now refer to as adult-onset diabetes. Even if these type of diabetes patients do not receive insulin from outside, serious complications like ketoacidosis do not occur. Often this type of diabetes can be controlled with exercise and dietary changes. Sometimes medicine has to be taken and in some patients insulin injections have to be given. Apart from this, in diabetes caused by other reasons (secondary diabetes) due to damage in the pancreas due to some disease or operation, the production of insulin decreases and the patient has to give insulin injections from outside. During pregnancy, if there is too much glucose in the blood of the expectant mother, it has side effects on the fetus. Complications related to diabetes are also more common in gestational diabetes and proper treatment can prevent these side effects. Many women have diabetes only during pregnancy and everything returns to normal after delivery. Such women may develop permanent diabetes after many years.
What causes childhood diabetes?
Even though scientists have not found the exact cause of diabetes till today, some facts related to the cause of diabetes have been found. One fact that all scientists accept is that childhood diabetes aka type-1 (insulin dependent) and adult-onset diabetes aka type-2 (non-insulin dependent) diabetes are due to different causes which have been discussed in different sections. Briefly speaking about the causes of type-1 (insulin-dependent) diabetes in childhood, it can be said that the cause of type-1 diabetes is an error in the body's immune system, which results in the destruction of insulin-producing cells (beta cells) in the pancreas 52 of the body's immune system. Soldiers (Whites) mount and gradually all beta cells are destroyed! But no, the matter is not so direct. Why does the immune system of some people make such a mistake? Why is diabetes more common in children of parents with diabetes? Can any environmental factor contribute to diabetes? etc. Many questions have been swirling for years. Although the search for answers to these questions can provide only partial answers, it is necessary to mention each important factor.
(1) Hereditary:
Childhood diabetes runs in the family. Among the close relatives of a diabetic patient, one in twenty people will be found to have diabetes. If one of the twins has diabetes, the other child also has a 50% chance of developing diabetes. The possibility of developing diabetes in different relatives of a diabetic patient is as follows:-
- (1) Five percent of the patient's siblings or parents;
- (2) six percent to children of diabetic fathers;
- (3) If both mother and father have diabetes, thirty percent for children;
- (4) A person whose siblings and parents have diabetes has a thirty percent chance of developing diabetes.
(2) Gene-nature of a person (HLA type):
Every person differs from other persons in some particular way. Each cell of a person has its own unique identity. All the cells of one person are identical to another. Different from all the cells of a person. Scientists identified these cells Studies have identified certain types of proteins responsible for this, known as HLA. Based on this protein, the body's immune system can distinguish between normal cells and normal cells. We have already seen that the failure of the immune system to recognize the host cells is responsible for childhood diabetes. Individuals with certain types of HLA proteins (eg HLA DQB1-0302/0201) are more prone to this type of immune system error.
(3) Viral infection:
Why does one get diabetes and not the other despite having the same inheritance or the same HLA type? While searching for a solution to this question, scientists found that there is a sudden increase in childhood diabetes after certain types of viral infections. According to a study from Sweden, the incidence of diabetes increases after chicken pox and a study from Britain after infection with the coxsackie virus. According to the current theory, viral infection causes certain changes either in the beta cells of the pancreas or in the cells of the immune system, due to which the immune system directly attacks the beta cells and destroys them, resulting in reduced insulin production and diabetes. Apart from this, any other external factor (medicine, food etc.) may also be responsible for the onset of diabetes, which is still being researched. Despite all these discoveries, it cannot be said with certainty whether a person will develop diabetes or not. Only statistical probabilities can be known about this.
What causes adult-onset (type-2) diabetes?
The cause of the very common type of adult-onset diabetes (known as type-2 diabetes) is not yet known. Possible reasons are discussed below. Hereditary
(1) Hereditary:
This diabetes is found in many members of the same family, but it is not known precisely who will inherit it and who will not. If type-2 diabetes occurs at a young age, it is known as MODY (Maturity Onset Diabetes of Young). This type of diabetes is definitely hereditary. This disease is directly inherited for three generations. In two identical twins, if one of them gets type-2 diabetes, the other will get it one hundred percent! Forty percent of the siblings and thirty-three percent of the children of diabetic patients develop diabetes. Diabetes occurs if there is a defect in the 11th pair of chromosomes in human cells.
(2) Age:
Type-2 diabetes is more common in people above forty years of age. Glucose control declines in most individuals with age. 1-2 mg in fasting glucose for every decade of age. / D.L. The increase is even greater in postprandial blood. Along with age, resistance to the action of blood insulin (resistant) increases. That is, as much as blood glucose was under control before insulin, insulin decreases with age. There are several factors behind this:
- (1) Fat accumulation and loss of muscle mass in the body with age.
- (2) Decline in physical exertion due to age.
- (3) Certain changes in diet (more food than energy intake) with age may be responsible for insulin resistance.
- (4) Finally, some medications—diuretics used for blood pressure, estrogen, steroids, antidepressants—can interfere with glucose control. And many old people are taking this type of medicine for some reason. Thus, advancing age provides many reasons for developing type-2 diabetes.
(3) Obesity:
Individuals with adult weight gain are also more likely to develop diabetes. A scale measurement known as body mass index is used to determine the degree of obesity. A person's weight | (in kilograms) divided by the square of one's height (in meters) can be calculated to calculate the body mass index. A healthy person's index is not more than 27. ==== besto A person with a body mass index of 40 or more has three times the chance of developing diabetes than a person with a normal index! But the relationship of this obesity with diabetes varies with human ancestry (RACE). American whites have about one-hundredth the rate of diabetes than obese people of Pima Indian descent. According to another study, not only obesity but also the location of excess fat in the body varies the risk of developing diabetes. The effect of insulin on the cells of a person with excess fat around the abdomen is greatly reduced. That is, a person who has accumulated more fat around the stomach is more likely to develop diabetes. (Whereas the fat deposited on legs, flanks or lower back does not increase the possibility of diabetes.)
(4) Sedentary life:
The more sedentary a person's life is, the higher the chances of diabetes. Exercise increases the effectiveness of insulin happens Body cells of athletes (exercisers) take on the task of glucose regulation with a very small amount of insulin. Whereas individuals living a sedentary life require more insulin for glucose regulation. As a person becomes richer, there are some changes in his eating habits, due to which the possibility of diabetes increases. About one percent of Indians living in villages and poor areas suffer from diabetes. Two percent of Indians living in big cities like Mumbai, Calcutta become victims of diabetes. While four percent of Indians living abroad are affected by diabetes.
(5) Other factors:
When the amount of other endocrine glands in the body (adrenaline, steroid, glucagon, without growth hormone) increases, due to anti-insulin effects, glucose regulation is disturbed and the disease of diabetes appears. His Similarly some drugs (diuretics, birth control pills, steroids etc.) can play a role in revealing hidden diabetes in the body. Diabetes due to mental stress? The possibility increases. Due to mental stress, the amount of anti-insulin endocrine glands in the body increases and the production of insulin decreases, as a result of which sugar in the blood starts to rise. In many patients, more than one cause is responsible for developing diabetes. Hereditary (genetic) factors play a role in filling the gun of diabetes. When the job of breaking the gun is done by habitation (external factors). So far, no single specific cause can be applied to all patients and the cause of diabetes remains unknown in most patients.
