BASIC FORMS OF DIABETES MELLITUS

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In general, two basic forms of diabetes mellitus exist. One form occurs mostly in adolescents, and the second later in life. The first is called juvenile, or growth-onset, diabetes mellitus, and the second form is called maturity-onset, or adult, diabetes mellitus. The difference between these two types is very interesting. The adult form of the disease is usually characterized by a gradual onset, and studies of the blood and pancreas in these persons typically demonstrate the presence of insulin, but in decreased amounts. These findings are compatible with the long-held theory about the origin of diabetes mellitus in that the disease is due to a premature wearing out of the pancreas with its resultant decrease in insulin production.

In the case of juvenile onset diabetes, examiners were surprised to find that some patients with this disease, shortly after its onset, had a normal amount of insulin circulating in their blood and that their pancreas also contained normal, or greater than normal, amounts of insulin. In a period of months, however, insulin completely disappeared from their blood and from their pancreas. This finding led to the postulation that there might be something present in these young people that was using up an abnormal amount of insulin, with the result that the pancreas becomes exhausted from over-stimulation and finally is unable to produce any insulin at all. This unknown agent could be a substance in the body that combines with insulin to prevent it from acting in a normal manner, or perhaps another organ in the body, such as the liver, might remove the insulin from the blood before it has a chance to function.

Another characteristic of this disease is its tendency to occur in relatives of persons who have the disease, or to be inherited. Relatives of diabetics have a chance of developing diabetes two and a half times greater than that of the general population. This inherited disease may first show symptoms at any age. A grandparent may have the disease, and then diabetes may occur in a grandchild during early adolescence. Finally, the child’s parent may develop the disease several years after it appeared in the child.

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BASIC FORMS OF DIABETES MELLITUSIn general, two basic forms of diabetes mellitus exist. One form occurs mostly in adolescents, and the second later in life. The first is called juvenile, or growth-onset, diabetes mellitus, and the second form is called maturity-onset, or adult, diabetes mellitus. The difference between these two types is very interesting. The adult form of the disease is usually characterized by a gradual onset, and studies of the blood and pancreas in these persons typically demonstrate the presence of insulin, but in decreased amounts. These findings are compatible with the long-held theory about the origin of diabetes mellitus in that the disease is due to a premature wearing out of the pancreas with its resultant decrease in insulin production.In the case of juvenile onset diabetes, examiners were surprised to find that some patients with this disease, shortly after its onset, had a normal amount of insulin circulating in their blood and that their pancreas also contained normal, or greater than normal, amounts of insulin. In a period of months, however, insulin completely disappeared from their blood and from their pancreas. This finding led to the postulation that there might be something present in these young people that was using up an abnormal amount of insulin, with the result that the pancreas becomes exhausted from over-stimulation and finally is unable to produce any insulin at all. This unknown agent could be a substance in the body that combines with insulin to prevent it from acting in a normal manner, or perhaps another organ in the body, such as the liver, might remove the insulin from the blood before it has a chance to function.Another characteristic of this disease is its tendency to occur in relatives of persons who have the disease, or to be inherited. Relatives of diabetics have a chance of developing diabetes two and a half times greater than that of the general population. This inherited disease may first show symptoms at any age. A grandparent may have the disease, and then diabetes may occur in a grandchild during early adolescence. Finally, the child’s parent may develop the disease several years after it appeared in the child.*2/309/5*