Disorders of glucose metabolism

Poor glucose metabolism leads to diabetes mellitus. Uncontrolled diabetes poses a significantly increased risk of developing macrovascular disease, especially coronary, cerebrovascular, and peripheral vascular disease. It also increases the chances of microvascular disease, including retinopathy, nephropathy, and neuropathy.

Diabetes is classified into two types-

Type 1 DM- due to deficient insulin secretion. Key features of this type are;

• Immune-mediated in over 90% of cases.
• It can occur in any age group but is most common in children and young adults.
• Circulating insulin is virtually absent, leading to a catabolic state with exogenous insulin required for treatment.

Type 2 DM- due to insulin resistance with a defect in compensatory insulin secretion. Key features of this type are;

• This condition occurs predominantly in adults but is now increasingly present in children and adolescents.
• Genetic and environmental factors combine, leading to insulin resistance and beta-cell loss.
• Treatment entails lifestyle changes and oral anti-diabetic drugs.

Reference

1. NICE. Type 1 diabetes in adults: diagnosis and management. NICE guideline NG17. Published August 2015, last updated August 2022
2. NICE. Type 2 diabetes in adults. Quality standard QS209. Published March 2023