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Diabetes Pathophysiology

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Diabetes Pathophysiology * The underlying pathophysiologic defect in type 1 diabetes is an autoimmune destruction of pancreatic beta cells. Following this destruction, the individual has an absolute insulin deficiency and no longer produces insulin. Autoimmune beta cell destruction is thought to be triggered by an environmental event, such as a viral infection. Genetically determined susceptibility factors increase the risk of such autoimmune phenomena. * About 90% of diabetic Americans have type 2 diabetes. The prevalence of type 2 diabetes is higher in African Americans, Native Americans, Hispanics, and Pacific Islanders than it is in Caucasians. Most type 2 diabetes patients are overweight, and most are diagnosed as adults. The genetic influence in type 2 diabetes is greater than that seen with type 1. While concordance rates between monozygous twins for type 1 diabetes are about 30 to 50%, the rate is approximately 90% for type 2 diabetes. Although the genetic predisposition to type 2 diabetes is strong, no single genetic defect has been found. In addition to genetic influences, acquired risk factors for type 2 diabetes include obesity, advancing age, and an inactive lifestyle.
CLINICAL MANIFESTATION * Type 1 Diabetes: About 5 to 10 percent of those with diabetes have type 1 diabetes. It's an autoimmune disease, meaning the body's own immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Patients with type 1 diabetes have very little or no insulin, and must take insulin everyday. Although the condition can appear at any age, typically it's diagnosed in children and young adults, which is why it was previously called juvenile diabetes. * Type 2 Diabetes: Accounting for 90 to 95 percent of those with diabetes, type 2 is the most common form. Usually, it's diagnosed in adults over age 40 and 80 percent of those

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