How to identify the classification and characteristics of diabetes?
1. Concept: Due to the destruction of islet β cells, endogenous insulin or C peptide is absolutely lacking, and ketoacidosis is prone to occur clinically.
2 according to the etiology and pathogenesis is divided into:
(1) Autoimmune diabetes: Formerly called IDDM, which means type I or juvenile onset diabetes. It is caused by cell-mediated autoimmune damage of islet β cells.
Its characteristics are as follows:
① Autoantibodies exist in the body, such as islet cell surface antibody (ICAs), insulin antibody (IAA), islet cell antibody (ICA) and so on.
② It occurs at any age, especially in adolescence, and the onset is more acute.
③ Insulin secretion is seriously insufficient, and the level of plasma C peptide is very low.
④ Treatment depends on insulin.
⑤ Multi-gene genetic susceptibility. Such as HLA-DR3 and DR4.
Virus infection (Coxsackie virus, influenza virus), chemicals and food ingredients can all induce diabetes.
(2) Idiopathic diabetes:
There are 1 diabetes symptoms, no obvious cause, different degrees of insulin deficiency, but no evidence of autoimmune reaction.
(2) Type II diabetes: non-insulin-dependent diabetes, that is, type II or adult-onset diabetes.
1. Concept: Diseases with different degrees of insulin secretion disorder and insulin resistance. Autoimmune damage of islet β cells does not occur.
2. Features:
Most patients (1) are obese, and the course of disease progresses slowly or repeatedly.
(2) The absolute value of insulin in plasma is not low, but its release is delayed after glucose stimulation.
(3) Autoantibodies such as 3)ICA are negative.
(4) Insensitive to insulin therapy.
3. According to the etiology and pathogenesis, it is divided into three categories.
The decrease of (1) insulin biological activity is caused by gene mutation.
(2) Insulin resistance: the sensitivity of liver and peripheral adipose tissue and muscle to insulin is reduced, leading to hyperglycemia with hyperinsulinemia.
(3) Abnormal insulin secretion.
(3) Special type diabetes mellitus: it is divided into 8 subtypes according to the etiology and pathogenesis:
1.β cell function genetic defect
2. Genetic defects of insulin action
3. Pancreatic exocrine diseases (pancreatic surgery, pancreatitis, cystic fibrosis, etc.). )
4. Endocrine diseases (hyperthyroidism, Cushing's disease, acromegaly, etc. )
5. Diabetes caused by drugs or chemicals
Be infected
7. Abnormal immune-mediated diabetes
8. Hereditary diabetes that may be related to diabetes.
For example, the following false statements about 1 type diabetes are
A. caused by autoimmune damage of islet β cells
B. Insulin secretion is absolutely insufficient
C. This is a polygenic genetic disease.
D. There are many autoantibodies.
E. the existence of insulin resistance
Answer E. Analysis: Insulin resistance is type 2 diabetes.
The above is a summary of the classification and characteristics of diabetes-related knowledge. For more basic knowledge of clinical medicine, please pay attention to the clinical medical knowledge base of Zhonggong Health Talent Network!