Insulin-Dependent Diabetes Mellitus (IDDM)

Synonyms

Autoimmune diabetes; Juvenile diabetes; Type 1 diabetes

Definition

Insulin-dependent diabetes mellitus (IDDM) is now referred to as type 1 diabetes (T1DM) and designates an elevation in blood glucose due to insufficient production of insulin thought to result from cell-mediated autoimmune destruction of insulin-producing pancreatic beta cells. Autoimmunity is manifested by mononuclear cell invasion of islets (insulitis) and the production of islet-specific antibodies, such as GAD (glutamic acid decarboxylase), IA-2 autoantibodies, and ICA (islet cell antibodies), detectable in ~85% of newly diagnosed patients. Genetic, environmental, and possibly other unknown factors contribute to disease susceptibility, which is most commonly manifested in the childhood or teenage years (hence the former designation of juvenile diabetes).

If not replaced, absolute insulin deficiency in T1DM results in severe hyperglycemia and diabetic ketoacidosis (DKA), which if left untreated can prove...