Diabetes Mellitus

Abstract

Diabetes mellitus (DM) is the fourth most common chronic disease of childhood (tooth decay is the first followed by obesity and asthma) and is characterized by elevated blood glucose caused by inadequate insulin production or insulin action that leads to disordered carbohydrate, lipid, and protein metabolism. This may derive from inadequate insulin secretion (the basic defect in type 1 DM or T1DM), from inadequate insulin action, or from both (both defects occur in type 2 DM or T2DM). Variations are found on these two themes with some overlap in the presentation of type 1 diabetes and type 2 diabetes. Until the last decades, type 1 DM was the most common diagnosis in subjects younger than 18 years with new-onset DM, but now type 2 DM is becoming more prevalent, and the incidence of T2DM exceeds the incidence of type 1 DM in American Indian teenagers with the incidence in other racial groups, Caucasians, rising. The differentiation between the two is not always straightforward in young patient.

Recent statistics from four geographic areas of the United States demonstrated a prevalence of type 1 diabetes in children of 1.93 per 1000 with a rise of about 20% in the preceding decade. The prevalence of type 2 diabetes in children was 0.46 per 1000 with a rise of 30% in the preceding decade.