Frederick Banting

The Big Diabetes Lie

Alternative Treatments for Diabetes

Get Instant Access

Alberti KGGM. Preventing insulin dependent diabetes mel-litus. Promising strategies but formidable hurdles still to clear. Br Med J 1993; 307: 1435-6

Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part I: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15: 539-53

American Diabetes Association. Type 2 diabetes in children and adolescents. Diabetes Care 2000; 23: 381-9

Diabetes care and research in Europe: the Saint Vincent declaration. Diabet Med 1990; 7: 360

Eisenbarth GS. Type I diabetes mellitus. A chronic autoimmune disease. N Engl J Med 1986; 314: 1360-8

Larsson H, Berglund G, Lindgarde F, Ahren B. Comparison of ADA and WHO criteria for diagnosis of diabetes and glucose intolerance. Diabetologia 1998; 41: 1124-5

MacFarlane IA. Diabetes mellitus and endocrine disease. In Pickup J, Williams G, eds. Textbook of Diabetes. Oxford: Blackwell Scientific Publications, 1991: 263-75

Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1998; 21 (Suppl): s5-19

Zimmet PZ, Tuomi T, Mackay IR, et al. Latent autoimmune diabetes mellitus in adults (LADA): the role of antibodies to glutamic acid decarboxylase in diagnosis and prediction of insulin dependency. Diabet Med 1994; 11: 299-303

James Collip
Figure 1 The discovery of insulin in 1922 is accredited to Frederick Banting and Charles Best (a medical student), seen above, supervised by JJR MacLeod and assisted by James Collip. The work was carried out at the University of Toronto
Frederick Banting Young
Figure 2 The same child as seen in Figure 2 in 1923 after insulin treatment became available following its discovery by the Toronto group. The effect of this new therapy was 'miraculous'
Frederick Banting Childhood
Figure 3 A 3-year-old child with type 1 diabetes mellitus, photographed in 1922 before insulin treatment was available. The only treatment then was a 'starvation' diet; patients rarely survived for more than 2 years

American Diabetes Association etiologic classification of diabetes mellitus

Starvation Diet Diabetes

Uncommon forms of insulin-mediated diabetes, e.g. 'stiff-man' syndrome, antiinsulin receptor antibodies

Infections, e.g. congenital rubella and cytomegalovirus

Gestational diabetes mellitus

Other specific types

Genetic defects of P-cell function, e.g. Chromosome 20, HNF-4a (MODY 1) Chromosome 7, glucokinase (MODY 2) Chromosome 12, HNF-la (MODY 3) Mitochondrial DNA

Genetic defects in insulin action, e.g Type A insulin resistance Leprechaunism

Rabson-Mendenhall syndrome Lipoatrophic diabetes

Diseases of the exocrine pancreas, e.g Pancreatitis

Trauma/pancreatectomy Neoplasia Cystic fibrosis Hemochromoatosis Fibrocalculous pancreatopathy

Endocrinopathies, e.g. acromegaly, Cushing's syndrome, glucagonoma, pheochromocytoma, hyperthyroidism and somatostatinoma

Drug- or chemical-induced diabetes, e.g. glucocorticoids, diazoxide, ^-adrenergic agonists and thiazides

Other genetic syndromes associated with diabetes, e.g. Down's, Klinefelter's, Turner's, Lawrence-Moon-Biedl and Prader-Willi syndromes, Friedreich's ataxia and myotonic dystrophy

Figure 6 The American Diabetes Association has proposed an etiologic classification of diabetes based on research findings over the past two decades. The nomenclature has changed from insulin-dependent diabetes to type 1 diabetes and from noninsulin diabetes mellitus to type 2 diabetes. All forms of diabetes are characterized according to their known etiologies, immunologic, genetic or otherwise. This opens up the concept of 'the diabetic syndrome'. HNF, hepatic nuclear factor; MODY, maturity-onset diabetes of the young

Diagnosis of diabetes mellitus positive if:

Diabetic Dermopathy

Figure 7 Although a definitive diagnosis of diabetes may be made using the glucose tolerance test, it is no longer recommended for routine clinical use. In the presence of diabetic symptoms, the diagnosis may be established by finding a random plasma glucose level of > 11.1 mmol/l (200mg/dl) or a fasting plasma glucose level of > 7.0mmol/l (126mg/dl) . Both impaired fasting glucose and impaired glucose tolerance are defined in the text

Was this article helpful?

0 0
Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

Get My Free Ebook


Post a comment