Discuss risk factors, pathogenesis, diagnosis and complications of type -1 & type-2diabetes mellitus

Risk Factors

Type 1 Diabetes Mellitus

1. Genetic Predisposition: A family history of type 1 diabetes increases risk.
2. Autoimmune Factors: The body’s immune system mistakenly attacks insulin-producing cells in the pancreas.
3. Environmental Triggers: Certain viruses (e.g., coxsackievirus) and possibly dietary factors may contribute to the onset.
4. Age: Typically presents in childhood or early adulthood, though it can occur at any age.

Type 2 Diabetes Mellitus

1. Obesity: Excess body fat, especially around the abdomen, is a significant risk factor.
2. Physical Inactivity: A sedentary lifestyle increases the likelihood of developing type 2 diabetes.
3. Age: Risk increases with age, particularly after 45 years.
4. Family History: A family history of diabetes also raises risks.
5. Ethnicity: Higher prevalence in certain ethnic groups, including African Americans, Hispanic Americans, and Native Americans.
6. Insulin Resistance: The body becomes less responsive to insulin, a hallmark of type 2 diabetes.

Pathogenesis

Type 1 Diabetes Mellitus

• Primarily an autoimmune condition where the immune system attacks and destroys pancreatic beta cells, leading to an absolute deficiency of insulin. This process is often preceded by genetic susceptibility paired with environmental factors.

Type 2 Diabetes Mellitus

• Characterized by insulin resistance, where cells fail to respond effectively to insulin. Over time, the pancreas can’t produce enough insulin to maintain normal glucose levels. Contributing factors include obesity, inactivity, and metabolic syndrome.

Diagnosis

1. Fasting Plasma Glucose Test: Measures blood sugar levels after overnight fasting; a level of 126 mg/dL or higher indicates diabetes.
2. Oral Glucose Tolerance Test (OGTT): This test measures blood glucose two hours after a person drinks a sugary solution; results of 200 mg/dL or higher confirm diabetes.
3. Hemoglobin A1c Test: An average blood sugar level over the past two to three months; a result of 6.5% or higher indicates diabetes.

Complications

Type 1 & Type 2 Diabetes Mellitus

1. Cardiovascular Disease: Increased risk of heart disease and stroke.
2. Neuropathy: Damage to nerves, leading to pain, tingling, or loss of sensation, particularly in the extremities.
3. Nephropathy: Kidney damage due to high blood sugar levels can lead to kidney failure.
4. Retinopathy: Damage to the blood vessels in the retina, potentially leading to blindness.
5. Foot Problems: Poor circulation and nerve damage can lead to serious foot conditions, including infections and amputations.
6. Skin Conditions: Increased susceptibility to infections and skin disorders.

Summary

Understanding the risk factors, pathogenesis, diagnosis, and complications of both types of diabetes mellitus is essential for prevention and management. While type 1 diabetes is largely autoimmune and typically diagnosed in younger individuals, type 2 diabetes often arises from lifestyle factors and is more common in adults. Early diagnosis and lifestyle modifications can significantly reduce complications.