The same blood glucose criteria apply to the diagnosis of all types of diabetes. The two main types are Type 1 (insulin-dependent diabetes or juvenile-onset diabetes previously) and Type 2 (non-insulin-dependent or maturity-onset diabetes previously).
People with Type 1 diabetes are usually:
♦ islet-cell antibody positive
♦ have rapid onset of symptoms (often severe)
♦ unable to survive without insulin treatment People with Type 2 diabetes are usually:
♦ not ketosis-prone
♦ islet-cell antibody negative
♦ have variable onset of symptoms (often slow and less severe)
♦ able to survive without insulin treatment
A subset of people with Type 2 diabetes have maturity-onset diabetes of the young (MODY). This usually starts under 25 years of age and forms 2-5 per cent of Type 2 diabetes. Fifty per cent of parents and 50 per cent of siblings have glucose intolerance; it is slowly progressive and seldom needs insulin. Various gene defects have been identified. Early-onset Type 2 diabetes starts between 25 and 40 years of age. Ninety per cent of parents and 68 per cent of siblings have glucose intolerance. It is associated with obesity. Insulin is often needed and microvascular complications are common. (Rehman 2001)
Some patients are difficult to classify but can still be treated on clinical and biochemical assessment. Tropical diabetes is not seen in Britain and is associated with pancreatic calculi and, in some instances, with malnutrition.
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