Glucose metabolism disorders 

Types of diabetes (prediabetes, type 1 and type 2) 

PreDmM = glucose intolerance, Islet cell–specific antibodies, Screening for 

prediabetes and DM should be considered in all individuals who are 

overweight or obese, regardless of age, and for all adults aged 45 years and 

older.

- severe insulin deficiency resulting from beta cell destruction, which 

produces hyperglycemia due to the altered metabolism of lipids, 

carbohydrates, and proteins

- abnormal secretion of insulin, resistance to the action of insulin in the 

target tissues, and/or an inadequate response at the level of the insulin 

receptor.

Types of diabetes- Two types: Type 1 and Type 2- Improper function of the hormone insulin, 

secreted by the pancreas. Hyperglycemia is a hallmark sign of diabetes.

Prediabetes: Impaired glucose tolerance (IGT) describes a prediabetic state of hyperglycemia 

where a 2-hour post-glucose load glycemic level is 140 to 199 mg/dL.

Type 1 (insulin deficiency)- Presents mostly during childhood. Genetic predisposition 

plus some sort of environmental trigger. Results in an auto-immune disorder in 

which the immune system attacks the beta cells of the pancreas to prevent them 

from producing insulin (decreases production). Inhibits this first step in the insulin 

pathway.

Type 2- Presents mostly during adulthood. Strongly associated with a genetic 

predisposition. Accompanied with other predisposing conditions, such as obesity or 

hypertension. Inability of these cells throughout the body to respond to insulin. The 

pancreas continues to secrete insulin. The cells throughout the body that are unable 

to adequately respond to it.

-induced diabetes- caused by medications Most commonly occurs with a group of 

medications that are known as glucocorticoids (steroids) such as in asthma or 

chrons. 

Presentation: acute, subacute, and asymptomatic

most severe presenting situation and can be life threatening for both type I and 

type II diabetes. very sick over a relatively short period of time, usually only a couple 

of days.

S/S: nausea, vomiting, and abdominal pain leads to severe dehydration. Confusion or 

unconscious as a result. In type I diabetes, this is known as diabetic ketoacidosis. 30% of 

individuals with type I diabetes will initially present before diagnosis. DKA- acidotic due 

to the production of ketoacids

Type 2 diabetes: 2% of 

individuals 

hyperosmolar nonketotic state- ketones are not produced. Can occur with either type I

or type II diabetes.

weeks to 

months.

S/S: Generally, just not feeling as well. Fatigue, increased thirst, frequent urination, or 

even weight loss. Most common form of presentation in Type 1 diabetes (70%). 

Type II diabetes affects nearly 10% of the population. 

Those with the risk factors of type II diabetes should be routinely screened. Most 

common means by which type II diabetes is diagnosed. 

Diagnostic criteria - ADA criteria for diagnosing DM -

Random BG >200 (week 5 quiz question)

3 Ps of DM: polyphagia, polydipsia, polyuria (week 5 quiz question)

least 8 hrs

-h PG ≥200 mg/dL (11.1 mmol/L) during OGTT. The test should be performed 

as described by the WHO, using a glucose load containing the equivalent of 

75-g anhydrous glucose load dissolved in water.

a method that is NGSP certified and standardized to the DCCT assay. 

patient with classic s/s of hyperglycemia or hyperglycemic crisis (polyuria, 

poly dipsia, weight loss), a random plasma glucose ≥200 mg/dL (11.1 mmol/L) Current 

guidelines for the diagnosis of DM include any one of the following:

• Glycosylated hemoglobin (A1C) of 6.5% or higher

• Symptoms of diabetes (e.g., polyuria, polydipsia, weight loss) plus a random plasma 

glucose level of 200 mg/dL or higher

• Fasting plasma glucose level of 126 mg/dL or higher (following 8 hours of no caloric 

intake)