Diabetes mellitus (DM), commonly referred to as diabetes, is a group
of metabolic disorders in which there are high blood sugar levels over
a prolonged period. Symptoms of high blood sugar include frequent
urination, increased thirst, and increased hunger. If left
untreated, diabetes can cause many complications. Acute
complications can include diabetic ketoacidosis, hyperosmolar
hyperglycemic state, or death. Serious long-term complications
include cardiovascular disease, stroke, chronic kidney disease, foot
ulcers, and damage to the eyes.
Diabetes is due to either the pancreas not producing enough insulin or
the cells of the body not responding properly to the insulin
produced. There are three main types of diabetes mellitus:
Type 1 DM results from the pancreas's failure to produce enough
insulin. This form was previously referred to as "insulin-dependent
diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is
Type 2 DM begins with insulin resistance, a condition in which cells
fail to respond to insulin properly. As the disease progresses a
lack of insulin may also develop. This form was previously referred
to as "non insulin-dependent diabetes mellitus" (NIDDM) or
"adult-onset diabetes". The most common cause is excessive body
weight and insufficient exercise.
Gestational diabetes is the third main form, and occurs when pregnant
women without a previous history of diabetes develop high blood sugar
Prevention and treatment involve maintaining a healthy diet, regular
physical exercise, a normal body weight, and avoiding use of
tobacco. Control of blood pressure and maintaining proper foot care
are important for people with the disease. Type 1 DM must be
managed with insulin injections. Type 2 DM may be treated with
medications with or without insulin.
Insulin and some oral
medications can cause low blood sugar. Weight loss surgery in
those with obesity is sometimes an effective measure in those with
type 2 DM.
Gestational diabetes usually resolves after the birth
of the baby.
As of 2015[update], an estimated 415 million people had diabetes
worldwide, with type 2 DM making up about 90% of the cases.
This represents 8.3% of the adult population, with equal rates in
both women and men. As of 2014[update], trends suggested the rate
would continue to rise. Diabetes at least doubles a person's risk
of early death. From 2012 to 2015, approximately 1.5 to 5.0 million
deaths each year resulted from diabetes. The global economic
cost of diabetes in 2014 was estimated to be US$612 billion. In
the United States, diabetes cost $245 billion in 2012.
1 Signs and symptoms
1.1 Diabetic emergencies
2.1 Type 1
2.2 Type 2
2.3 Gestational diabetes
2.4 Maturity onset diabetes of the young
2.5 Other types
9 Society and culture
10 Other animals
13 Further reading
14 External links
Signs and symptoms
Overview of the most significant symptoms of diabetes
The classic symptoms of untreated diabetes are weight loss, polyuria
(increased urination), polydipsia (increased thirst), and polyphagia
(increased hunger). Symptoms may develop rapidly (weeks or months)
in type 1 DM, while they usually develop much more slowly and may
be subtle or absent in type 2 DM.
Several other signs and symptoms can mark the onset of diabetes
although they are not specific to the disease. In addition to the
known ones above, they include blurry vision, headache, fatigue, slow
healing of cuts, and itchy skin. Prolonged high blood glucose can
cause glucose absorption in the lens of the eye, which leads to
changes in its shape, resulting in vision changes. A number of skin
rashes that can occur in diabetes are collectively known as diabetic
Low blood sugar is common in persons with type 1 and type 2 DM. Most
cases are mild and are not considered medical emergencies. Effects can
range from feelings of unease, sweating, trembling, and increased
appetite in mild cases to more serious issues such as confusion,
changes in behavior such as aggressiveness, seizures, unconsciousness,
and (rarely) permanent brain damage or death in severe cases.
Moderate hypoglycemia may easily be mistaken for drunkenness;
rapid breathing and sweating, cold, pale skin are characteristic of
hypoglycemia but not definitive. Mild to moderate cases are
self-treated by eating or drinking something high in sugar. Severe
cases can lead to unconsciousness and must be treated with intravenous
glucose or injections with glucagon.
People (usually with type 1 DM) may also experience episodes of
diabetic ketoacidosis, a metabolic disturbance characterized by
nausea, vomiting and abdominal pain, the smell of acetone on the
breath, deep breathing known as Kussmaul breathing, and in severe
cases a decreased level of consciousness.
A rare but equally severe possibility is hyperosmolar hyperglycemic
state, which is more common in type 2 DM and is mainly the result
Main article: Complications of diabetes mellitus
All forms of diabetes increase the risk of long-term complications.
These typically develop after many years (10–20) but may be the
first symptom in those who have otherwise not received a diagnosis
before that time.
The major long-term complications relate to damage to blood vessels.
Diabetes doubles the risk of cardiovascular disease and about 75%
of deaths in diabetics are due to coronary artery disease. Other
"macrovascular" diseases are stroke, and peripheral artery disease.
The primary complications of diabetes due to damage in small blood
vessels include damage to the eyes, kidneys, and nerves. Damage to
the eyes, known as diabetic retinopathy, is caused by damage to the
blood vessels in the retina of the eye, and can result in gradual
vision loss and blindness. Diabetes also increases your risk of
having glaucoma, cataracts, and other eye problems. It is recommended
that diabetics visit an eye doctor once a year. Damage to the
kidneys, known as diabetic nephropathy, can lead to tissue scarring,
urine protein loss, and eventually chronic kidney disease, sometimes
requiring dialysis or kidney transplantation. Damage to the nerves
of the body, known as diabetic neuropathy, is the most common
complication of diabetes. The symptoms can include numbness,
tingling, pain, and altered pain sensation, which can lead to damage
to the skin. Diabetes-related foot problems (such as diabetic foot
ulcers) may occur, and can be difficult to treat, occasionally
requiring amputation. Additionally, proximal diabetic neuropathy
causes painful muscle atrophy and weakness.
There is a link between cognitive deficit and diabetes. Compared to
those without diabetes, those with the disease have a 1.2 to 1.5-fold
greater rate of decline in cognitive function. Being diabetic,
especially when on insulin, increases the risk of falls in older
Comparison of type 1 and 2 diabetes
Type 1 diabetes
Type 2 diabetes
Age at onset
Mostly in children
Mostly in adults
Thin or normal
Low or absent
in identical twins
Diabetes mellitus is classified into four broad categories:
type 1, type 2, gestational diabetes, and "other specific
types". The "other specific types" are a collection of a few dozen
individual causes. Diabetes is a more variable disease than once
thought and people may have combinations of forms. The term
"diabetes", without qualification, usually refers to diabetes
Diabetes mellitus type 1
Type 1 diabetes mellitus is characterized by loss of the
insulin-producing beta cells of the pancreatic islets, leading to
insulin deficiency. This type can be further classified as
immune-mediated or idiopathic. The majority of type 1 diabetes is
of the immune-mediated nature, in which a T cell-mediated autoimmune
attack leads to the loss of beta cells and thus insulin. It causes
approximately 10% of diabetes mellitus cases in North America and
Europe. Most affected people are otherwise healthy and of a healthy
weight when onset occurs. Sensitivity and responsiveness to insulin
are usually normal, especially in the early stages. Type 1
diabetes can affect children or adults, but was traditionally termed
"juvenile diabetes" because a majority of these diabetes cases were in
"Brittle" diabetes, also known as unstable diabetes or labile
diabetes, is a term that was traditionally used to describe the
dramatic and recurrent swings in glucose levels, often occurring for
no apparent reason in insulin-dependent diabetes. This term, however,
has no biologic basis and should not be used. Still, type 1
diabetes can be accompanied by irregular and unpredictable high blood
sugar levels, frequently with ketosis, and sometimes with serious low
blood sugar levels. Other complications include an impaired
counterregulatory response to low blood sugar, infection,
gastroparesis (which leads to erratic absorption of dietary
carbohydrates), and endocrinopathies (e.g., Addison's disease).
These phenomena are believed to occur no more frequently than in 1% to
2% of persons with type 1 diabetes.
Autoimmune attack in type 1 diabetes.
Type 1 diabetes is partly inherited, with multiple genes,
including certain HLA genotypes, known to influence the risk of
diabetes. In genetically susceptible people, the onset of diabetes can
be triggered by one or more environmental factors, such as a viral
infection or diet. Several viruses have been implicated, but to date
there is no stringent evidence to support this hypothesis in
humans. Among dietary factors, data suggest that gliadin (a
protein present in gluten) may play a role in the development of type
1 diabetes, but the mechanism is not fully understood.
Diabetes mellitus type 2
Reduced insulin secretion and absorption leads to high glucose content
in the blood.
Type 2 DM is characterized by insulin resistance, which may be
combined with relatively reduced insulin secretion. The defective
responsiveness of body tissues to insulin is believed to involve the
insulin receptor. However, the specific defects are not known.
Diabetes mellitus cases due to a known defect are classified
separately. Type 2 DM is the most common type of diabetes
In the early stage of type 2, the predominant abnormality is
reduced insulin sensitivity. At this stage, high blood sugar can be
reversed by a variety of measures and medications that improve insulin
sensitivity or reduce the liver's glucose production.
Type 2 DM is primarily due to lifestyle factors and genetics.
A number of lifestyle factors are known to be important to the
development of type 2 DM, including obesity (defined by a body
mass index of greater than 30), lack of physical activity, poor diet,
stress, and urbanization. Excess body fat is associated with 30%
of cases in those of Chinese and Japanese descent, 60–80% of cases
in those of European and African descent, and 100% of Pima Indians and
Pacific Islanders. Even those who are not obese often have a high
Dietary factors also influence the risk of developing type 2 DM.
Consumption of sugar-sweetened drinks in excess is associated with an
increased risk. The type of fats in the diet is also
important, with saturated fat and trans fats increasing the risk and
polyunsaturated and monounsaturated fat decreasing the risk.
Eating lots of white rice also may increase the risk of diabetes.
A lack of physical activity is believed to cause 7% of cases.
Main article: Gestational diabetes
Gestational diabetes mellitus (GDM) resembles type 2 DM in
several respects, involving a combination of relatively inadequate
insulin secretion and responsiveness. It occurs in about 2–10% of
all pregnancies and may improve or disappear after delivery.
However, after pregnancy approximately 5–10% of women with
gestational diabetes are found to have diabetes mellitus, most
commonly type 2.
Gestational diabetes is fully treatable, but
requires careful medical supervision throughout the pregnancy.
Management may include dietary changes, blood glucose monitoring, and
in some cases, insulin may be required.
Though it may be transient, untreated gestational diabetes can damage
the health of the fetus or mother. Risks to the baby include
macrosomia (high birth weight), congenital heart and central nervous
system abnormalities, and skeletal muscle malformations. Increased
levels of insulin in a fetus's blood may inhibit fetal surfactant
production and cause respiratory distress syndrome. A high blood
bilirubin level may result from red blood cell destruction. In severe
cases, perinatal death may occur, most commonly as a result of poor
placental perfusion due to vascular impairment.
Labor induction may be
indicated with decreased placental function. A
Caesarean section may
be performed if there is marked fetal distress or an increased risk of
injury associated with macrosomia, such as shoulder dystocia.[citation
Maturity onset diabetes of the young
Maturity onset diabetes of the young (MODY) is an autosomal dominant
inherited form of diabetes, due to one of several single-gene
mutations causing defects in insulin production. It is
significantly less common than the three main types. The name of this
disease refers to early hypotheses as to its nature. Being due to a
defective gene, this disease varies in age at presentation and in
severity according to the specific gene defect; thus there are at
least 13 subtypes of MODY. People with
MODY often can control it
without using insulin.
Prediabetes indicates a condition that occurs when a person's blood
glucose levels are higher than normal but not high enough for a
diagnosis of type 2 DM. Many people destined to develop
type 2 DM spend many years in a state of prediabetes.
Latent autoimmune diabetes of adults
Latent autoimmune diabetes of adults (LADA) is a condition in which
type 1 DM develops in adults. Adults with LADA are frequently
initially misdiagnosed as having type 2 DM, based on age rather
Some cases of diabetes are caused by the body's tissue receptors not
responding to insulin (even when insulin levels are normal, which is
what separates it from type 2 diabetes); this form is very
uncommon. Genetic mutations (autosomal or mitochondrial) can lead to
defects in beta cell function. Abnormal insulin action may also have
been genetically determined in some cases. Any disease that causes
extensive damage to the pancreas may lead to diabetes (for example,
chronic pancreatitis and cystic fibrosis). Diseases associated with
excessive secretion of insulin-antagonistic hormones can cause
diabetes (which is typically resolved once the hormone excess is
removed). Many drugs impair insulin secretion and some toxins damage
pancreatic beta cells. The
ICD-10 (1992) diagnostic entity,
malnutrition-related diabetes mellitus (MRDM or MMDM,
E12), was deprecated by the
World Health Organization
World Health Organization when the current
taxonomy was introduced in 1999.
Other forms of diabetes mellitus include congenital diabetes, which is
due to genetic defects of insulin secretion, cystic fibrosis-related
diabetes, steroid diabetes induced by high doses of glucocorticoids,
and several forms of monogenic diabetes.
"Type 3 diabetes" has been suggested as a term for Alzheimer's disease
as the underlying processes may involve insulin resistance by the
The following is a comprehensive list of other causes of diabetes:
Genetic defects of β-cell function
Maturity onset diabetes of the young
Mitochondrial DNA mutations
Genetic defects in insulin processing or insulin action
Defects in proinsulin conversion
Insulin gene mutations
Insulin receptor mutations
Exocrine pancreatic defects
Growth hormone excess (acromegaly)
A 2018 study suggested that three types should be abandoned as too
simplistic. It classified diabetes into five subgroups, with what
is typically described as type 1 and autoimmune late-onset diabetes
categorized as one group, whereas type 2 encompasses four categories.
This is hoped to improve diabetes treatment by tailoring it more
specifically to the subgroups.
The fluctuation of blood sugar (red) and the sugar-lowering hormone
insulin (blue) in humans during the course of a day with three meals.
One of the effects of a sugar-rich vs a starch-rich meal is
Mechanism of insulin release in normal pancreatic beta cells. Insulin
production is more or less constant within the beta cells. Its release
is triggered by food, chiefly food containing absorbable glucose.
Insulin is the principal hormone that regulates the uptake of glucose
from the blood into most cells of the body, especially liver, adipose
tissue and muscle, except smooth muscle, in which insulin acts via the
IGF-1. Therefore, deficiency of insulin or the insensitivity of its
receptors play a central role in all forms of diabetes mellitus.
The body obtains glucose from three main sources: the intestinal
absorption of food; the breakdown of glycogen, the storage form of
glucose found in the liver; and gluconeogenesis, the generation of
glucose from non-carbohydrate substrates in the body. Insulin
plays a critical role in balancing glucose levels in the body. Insulin
can inhibit the breakdown of glycogen or the process of
gluconeogenesis, it can stimulate the transport of glucose into fat
and muscle cells, and it can stimulate the storage of glucose in the
form of glycogen.
Insulin is released into the blood by beta cells (β-cells), found in
the islets of Langerhans in the pancreas, in response to rising levels
of blood glucose, typically after eating.
Insulin is used by about
two-thirds of the body's cells to absorb glucose from the blood for
use as fuel, for conversion to other needed molecules, or for storage.
Lower glucose levels result in decreased insulin release from the beta
cells and in the breakdown of glycogen to glucose. This process is
mainly controlled by the hormone glucagon, which acts in the opposite
manner to insulin.
If the amount of insulin available is insufficient, or if cells
respond poorly to the effects of insulin (insulin insensitivity or
insulin resistance), or if the insulin itself is defective, then
glucose will not be absorbed properly by the body cells that require
it, and it will not be stored appropriately in the liver and muscles.
The net effect is persistently high levels of blood glucose, poor
protein synthesis, and other metabolic derangements, such as
When the glucose concentration in the blood remains high over time,
the kidneys will reach a threshold of reabsorption, and glucose will
be excreted in the urine (glycosuria). This increases the osmotic
pressure of the urine and inhibits reabsorption of water by the
kidney, resulting in increased urine production (polyuria) and
increased fluid loss. Lost blood volume will be replaced osmotically
from water held in body cells and other body compartments, causing
dehydration and increased thirst (polydipsia).
Glycated hemoglobin and
Glucose tolerance test
WHO diabetes diagnostic criteria edit
2 hour glucose
Impaired fasting glycaemia
≥6.1(≥110) & <7.0(<126)
Impaired glucose tolerance
Diabetes mellitus is characterized by recurrent or persistent high
blood sugar, and is diagnosed by demonstrating any one of the
Fasting plasma glucose level ≥ 7.0 mmol/l (126 mg/dl)
Plasma glucose ≥ 11.1 mmol/l (200 mg/dl) two hours
after a 75 g oral glucose load as in a glucose tolerance test
Symptoms of high blood sugar and casual plasma glucose
≥ 11.1 mmol/l (200 mg/dl)
Glycated hemoglobin (HbA1C) ≥ 48 mmol/mol (≥ 6.5
A positive result, in the absence of unequivocal high blood sugar,
should be confirmed by a repeat of any of the above methods on a
different day. It is preferable to measure a fasting glucose level
because of the ease of measurement and the considerable time
commitment of formal glucose tolerance testing, which takes two hours
to complete and offers no prognostic advantage over the fasting
test. According to the current definition, two fasting glucose
measurements above 126 mg/dl (7.0 mmol/l) is considered
diagnostic for diabetes mellitus.
World Health Organization
World Health Organization people with fasting glucose levels
from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to
have impaired fasting glucose. people with plasma glucose at or
above 7.8 mmol/l (140 mg/dl), but not over 11.1 mmol/l
(200 mg/dl), two hours after a 75 g oral glucose load are
considered to have impaired glucose tolerance. Of these two
prediabetic states, the latter in particular is a major risk factor
for progression to full-blown diabetes mellitus, as well as
cardiovascular disease. The
American Diabetes Association
American Diabetes Association since
2003 uses a slightly different range for impaired fasting glucose of
5.6 to 6.9 mmol/l (100 to 125 mg/dl).
Glycated hemoglobin is better than fasting glucose for determining
risks of cardiovascular disease and death from any cause.
See also: Prevention of diabetes mellitus type 2
There is no known preventive measure for type 1 diabetes.
Type 2 diabetes – which accounts for 85–90% of all
cases – can often be prevented or delayed by maintaining a
normal body weight, engaging in physical activity, and consuming a
healthy diet. Higher levels of physical activity (more than 90
minutes per day) reduce the risk of diabetes by 28%. Dietary
changes known to be effective in helping to prevent diabetes include
maintaining a diet rich in whole grains and fiber, and choosing good
fats, such as the polyunsaturated fats found in nuts, vegetable oils,
and fish. Limiting sugary beverages and eating less red meat and
other sources of saturated fat can also help prevent diabetes.
Tobacco smoking is also associated with an increased risk of diabetes
and its complications, so smoking cessation can be an important
preventive measure as well.
The relationship between type 2 diabetes and the main modifiable risk
factors (excess weight, unhealthy diet, physical inactivity and
tobacco use) is similar in all regions of the world. There is growing
evidence that the underlying determinants of diabetes are a reflection
of the major forces driving social, economic and cultural change:
globalization, urbanization, population aging, and the general health
Main article: Diabetes management
Overview of management
Diabetes mellitus is a chronic disease, for which there is no known
cure except in very specific situations. Management concentrates
on keeping blood sugar levels as close to normal, without causing low
blood sugar. This can usually be accomplished with a healthy diet,
exercise, weight loss, and use of appropriate medications (insulin in
the case of type 1 diabetes; oral medications, as well as
possibly insulin, in type 2 diabetes).[medical citation needed]
Learning about the disease and actively participating in the treatment
is important, since complications are far less common and less severe
in people who have well-managed blood sugar levels. The goal
of treatment is an HbA1C level of 6.5%, but should not be lower than
that, and may be set higher. Attention is also paid to other
health problems that may accelerate the negative effects of diabetes.
These include smoking, elevated cholesterol levels, obesity, high
blood pressure, and lack of regular exercise. Specialized footwear
is widely used to reduce the risk of ulceration, or re-ulceration, in
at-risk diabetic feet. Evidence for the efficacy of this remains
See also: Diabetic diet
People with diabetes can benefit from education about the disease and
treatment, good nutrition to achieve a normal body weight, and
exercise, with the goal of keeping both short-term and long-term blood
glucose levels within acceptable bounds. In addition, given the
associated higher risks of cardiovascular disease, lifestyle
modifications are recommended to control blood pressure.
There is no single dietary pattern that is best for all people with
diabetes. For overweight people with type 2 diabetes, any diet that
the person will adhere to and achieve weight loss on is
See also: Anti-diabetic medication
Medications used to treat diabetes do so by lowering blood sugar
levels. There are a number of different classes of anti-diabetic
medications. Some are available by mouth, such as metformin, while
others are only available by injection such as GLP-1 agonists.
Type 1 diabetes can only be treated with insulin, typically with
a combination of regular and NPH insulin, or synthetic insulin
Metformin is generally recommended as a first line treatment for
type 2 diabetes, as there is good evidence that it decreases
mortality. It works by decreasing the liver's production of
glucose. Several other groups of drugs, mostly given by mouth, may
also decrease blood sugar in type II DM. These include agents that
increase insulin release, agents that decrease absorption of sugar
from the intestines, and agents that make the body more sensitive to
insulin. When insulin is used in type 2 diabetes, a
long-acting formulation is usually added initially, while continuing
oral medications. Doses of insulin are then increased to
Since cardiovascular disease is a serious complication associated with
diabetes, some have recommended blood pressure levels below
130/80 mmHg. However, evidence supports less than or equal to
somewhere between 140/90 mmHg to 160/100 mmHg; the only
additional benefit found for blood pressure targets beneath this range
was an isolated decrease in stroke risk, and this was accompanied by
an increased risk of other serious adverse events. A 2016
review found potential harm to treating lower than 140 mmHg. Among
medications that lower blood pressure, angiotensin converting enzyme
inhibitors (ACEIs) improve outcomes in those with DM while the similar
medications angiotensin receptor blockers (ARBs) do not. Aspirin
is also recommended for people with cardiovascular problems, however
routine use of aspirin has not been found to improve outcomes in
Weight loss surgery in those with obesity and type two diabetes is
often an effective measure. Many are able to maintain normal blood
sugar levels with little or no medications following surgery and
long-term mortality is decreased. There is, however, a short-term
mortality risk of less than 1% from the surgery. The body mass
index cutoffs for when surgery is appropriate are not yet clear.
It is recommended that this option be considered in those who are
unable to get both their weight and blood sugar under control.
A pancreas transplant is occasionally considered for people with
type 1 diabetes who have severe complications of their disease,
including end stage kidney disease requiring kidney
In countries using a general practitioner system, such as the United
Kingdom, care may take place mainly outside hospitals, with
hospital-based specialist care used only in case of complications,
difficult blood sugar control, or research projects. In other
circumstances, general practitioners and specialists share care in a
team approach. Home telehealth support can be an effective management
Main article: Epidemiology of diabetes mellitus
Rates of diabetes worldwide in 2000 (per 1,000 inhabitants) – world
average was 2.8%.
Diabetes mellitus deaths per million persons in 2012
As of 2016, 422 million people have diabetes worldwide, up from an
estimated 382 million people in 2013 and from 108 million in
1980. Accounting for the shifting age structure of the global
population, the prevalence of diabetes is 8.5% among adults, nearly
double the rate of 4.7% in 1980. Type 2 makes up about 90% of
the cases. Some data indicate rates are roughly equal in women
and men, but male excess in diabetes has been found in many
populations with higher type 2 incidence, possibly due to sex-related
differences in insulin sensitivity, consequences of obesity and
regional body fat deposition, and other contributing factors such as
high blood pressure, tobacco smoking, and alcohol intake.
World Health Organization
World Health Organization (WHO) estimates that diabetes mellitus
resulted in 1.5 million deaths in 2012, making it the 8th leading
cause of death. However another 2.2 million deaths worldwide
were attributable to high blood glucose and the increased risks of
cardiovascular disease and other associated complications (e.g. kidney
failure), which often lead to premature death and are often listed as
the underlying cause on death certificates rather than
diabetes. For example, in 2014, the International Diabetes
Federation (IDF) estimated that diabetes resulted in 4.9 million
deaths worldwide, using modeling to estimate the total number of
deaths that could be directly or indirectly attributed to
Diabetes mellitus occurs throughout the world but is more common
(especially type 2) in more developed countries. The greatest increase
in rates has however been seen in low- and middle-income
countries, where more than 80% of diabetic deaths occur. The
fastest prevalence increase is expected to occur in Asia and Africa,
where most people with diabetes will probably live in 2030. The
increase in rates in developing countries follows the trend of
urbanization and lifestyle changes, including increasingly sedentary
lifestyles, less physically demanding work and the global nutrition
transition, marked by increased intake of foods that are high
energy-dense but nutrient-poor (often high in sugar and saturated
fats, sometimes referred to as the "Western-style" diet).
Main article: History of diabetes
Diabetes was one of the first diseases described, with an
Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of
the urine". The
Ebers papyrus includes a recommendation for a
drink to be taken in such cases. The first described cases are
believed to be of type 1 diabetes. Indian physicians around
the same time identified the disease and classified it as madhumeha or
"honey urine", noting the urine would attract ants.
The term "diabetes" or "to pass through" was first used in
230 BCE by the Greek Apollonius of Memphis. The disease was
considered rare during the time of the Roman empire, with Galen
commenting he had only seen two cases during his career. This is
possibly due to the diet and lifestyle of the ancients, or because the
clinical symptoms were observed during the advanced stage of the
Galen named the disease "diarrhea of the urine" (diarrhea
The earliest surviving work with a detailed reference to diabetes is
Aretaeus of Cappadocia
Aretaeus of Cappadocia (2nd or early 3rd century CE). He
described the symptoms and the course of the disease, which he
attributed to the moisture and coldness, reflecting the beliefs of the
"Pneumatic School". He hypothesized a correlation of diabetes with
other diseases, and he discussed differential diagnosis from the
snakebite which also provokes excessive thirst. His work remained
unknown in the West until 1552, when the first
Latin edition was
published in Venice.
Type 1 and type 2 diabetes were identified as separate
conditions for the first time by the Indian physicians
Charaka in 400–500 CE with type 1 associated with youth
and type 2 with being overweight. The term "mellitus" or
"from honey" was added by the Briton John Rolle in the late 1700s to
separate the condition from diabetes insipidus, which is also
associated with frequent urination. Effective treatment was not
developed until the early part of the 20th century, when Canadians
Frederick Banting and
Charles Herbert Best
Charles Herbert Best isolated and purified
insulin in 1921 and 1922. This was followed by the development of
the long-acting insulin NPH in the 1940s.
The word diabetes (/ˌdaɪ.əˈbiːtiːz/ or /ˌdaɪ.əˈbiːtɪs/)
Latin diabētēs, which in turn comes from Ancient Greek
διαβήτης (diabētēs), which literally means "a passer
through; a siphon".
Ancient Greek physician Aretaeus of
Cappadocia (fl. 1st century CE) used that word, with the intended
meaning "excessive discharge of urine", as the name for the
disease. Ultimately, the word comes from Greek
διαβαίνειν (diabainein), meaning "to pass through,"
which is composed of δια- (dia-), meaning "through" and
βαίνειν (bainein), meaning "to go". The word "diabetes" is
first recorded in English, in the form diabete, in a medical text
written around 1425.
The word mellitus (/məˈlaɪtəs/ or /ˈmɛlɪtəs/) comes from the
Latin word mellītus, meaning "mellite" (i.e. sweetened
with honey; honey-sweet). The
Latin word comes from mell-,
which comes from mel, meaning "honey"; sweetness;
pleasant thing, and the suffix -ītus, whose meaning is the
same as that of the English suffix "-ite". It was Thomas Willis
who in 1675 added "mellitus" to the word "diabetes" as a designation
for the disease, when he noticed the urine of a diabetic had a sweet
taste (glycosuria). This sweet taste had been noticed in urine by the
ancient Greeks, Chinese, Egyptians, Indians, and Persians.
Society and culture
Further information: List of films featuring diabetes
The 1989 "St. Vincent Declaration" was the result of
international efforts to improve the care accorded to those with
diabetes. Doing so is important not only in terms of quality of life
and life expectancy but also economically – expenses due to
diabetes have been shown to be a major drain on health – and
productivity-related resources for healthcare systems and governments.
Several countries established more and less successful national
diabetes programmes to improve treatment of the disease.
People with diabetes who have neuropathic symptoms such as numbness or
tingling in feet or hands are twice as likely to be unemployed as
those without the symptoms.
In 2010, diabetes-related emergency room (ER) visit rates in the
United States were higher among people from the lowest income
communities (526 per 10,000 population) than from the highest income
communities (236 per 10,000 population). Approximately 9.4% of
diabetes-related ER visits were for the uninsured.
The term "type 1 diabetes" has replaced several former terms,
including childhood-onset diabetes, juvenile diabetes, and
insulin-dependent diabetes mellitus (IDDM). Likewise, the term
"type 2 diabetes" has replaced several former terms, including
adult-onset diabetes, obesity-related diabetes, and
noninsulin-dependent diabetes mellitus (NIDDM). Beyond these two
types, there is no agreed-upon standard nomenclature.
Diabetes mellitus is also occasionally known as "sugar diabetes" to
differentiate it from diabetes insipidus.
Diabetes in dogs
Diabetes in dogs and Diabetes in cats
In animals, diabetes is most commonly encountered in dogs and cats.
Middle-aged animals are most commonly affected. Female dogs are twice
as likely to be affected as males, while according to some sources,
male cats are also more prone than females. In both species, all
breeds may be affected, but some small dog breeds are particularly
likely to develop diabetes, such as Miniature Poodles.
Feline diabetes mellitus is strikingly similar to human type 2
diabetes. The Burmese breed, along with the Russian Blue, Abyssinian,
and Norwegian Forest cat breeds, showed an increased risk of DM, while
several breeds showed a lower risk. There is an association between
overweight and an increased risk of feline diabetes.
The symptoms may relate to fluid loss and polyuria, but the course may
also be insidious. Diabetic animals are more prone to infections. The
long-term complications recognized in humans are much rarer in
animals. The principles of treatment (weight loss, oral antidiabetics,
subcutaneous insulin) and management of emergencies (e.g.
ketoacidosis) are similar to those in humans.
Inhalable insulin has been developed. The original products were
withdrawn due to side effects. Afrezza, under development by the
pharmaceuticals company MannKind Corporation, was approved by the FDA
for general sale in June 2014. An advantage to inhaled insulin is
that it may be more convenient and easy to use.
Transdermal insulin in the form of a cream has been developed and
trials are being conducted on people with type 2
^ "Diabetes Blue Circle Symbol". International Diabetes Federation. 17
March 2006. Archived from the original on 5 August 2007.
^ a b c d e f g h i j k l m n o p q r s t u v w x "Diabetes Fact sheet
N°312". WHO. October 2013. Archived from the original on 26 August
2013. Retrieved 25 March 2014.
^ a b Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN (July 2009).
"Hyperglycemic crises in adult patients with diabetes". Diabetes Care.
32 (7): 1335–43. doi:10.2337/dc09-9032. PMC 2699725 .
^ a b c d Ripsin CM, Kang H, Urban RJ (January 2009). "Management of
blood glucose in type 2 diabetes mellitus" (PDF). American Family
Physician. 79 (1): 29–36. PMID 19145963. Archived (PDF) from
the original on 2013-05-05.
^ a b c d "Update 2015". ID F. International Diabetes Federation.
p. 13. Archived from the original on 22 March 2016. Retrieved 21
^ a b c d "The top 10 causes of death Fact sheet N°310". World Health
Organization. October 2013. Archived from the original on 30 May
^ "About diabetes". World Health Organization. Archived from the
original on 31 March 2014. Retrieved 4 April 2014.
^ a b c d e f Shoback DG, Gardner D, eds. (2011). "Chapter 17".
Greenspan's basic & clinical endocrinology (9th ed.). New York:
McGraw-Hill Medical. ISBN 0-07-162243-8.
^ RSSDI textbook of diabetes mellitus (Rev. 2nd ed.). Jaypee Brothers
Medical Publishers. 2012. p. 235. ISBN 9789350254899.
Archived from the original on 14 October 2015.
^ Rippe RS, Irwin JM, eds. (2010). Manual of intensive care medicine
(5th ed.). Wolters Kluwer Health/Lippincott Williams & Wilkins.
p. 549. ISBN 9780781799928.
^ a b Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E,
Baxter L, Clegg AJ (September 2009). "The clinical effectiveness and
cost-effectiveness of bariatric (weight loss) surgery for obesity: a
systematic review and economic evaluation". Health Technology
Assessment. 13 (41): 1–190, 215–357, iii–iv.
doi:10.3310/hta13410. PMID 19726018.
^ Cash, Jill (2014). Family Practice Guidelines (3rd ed.). Springer.
p. 396. ISBN 9780826168757. Archived from the original on 31
^ a b c d Williams textbook of endocrinology (12th ed.).
Elsevier/Saunders. pp. 1371–1435.
^ a b c Shi Y, Hu FB (June 2014). "The global implications of diabetes
and cancer". Lancet. 383 (9933): 1947–8.
doi:10.1016/S0140-6736(14)60886-2. PMID 24910221.
^ a b c Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M,
et al. (December 2012). "Years lived with disability (YLDs) for 1160
sequelae of 289 diseases and injuries 1990-2010: a systematic analysis
for the Global Burden of Disease Study 2010". Lancet. 380 (9859):
^ a b "Annual Report 2014" (PDF). IDF. International Diabetes
Federation. Archived from the original (PDF) on 17 October 2016.
Retrieved 13 July 2016.
^ a b IDF DIABETES ATLAS (PDF) (6th ed.). International Diabetes
Federation. 2013. p. 7. ISBN 2930229853. Archived from the
original (PDF) on 9 June 2014.
^ "Economic costs of diabetes in the U.S. in 2012". Diabetes Care. 36
(4): 1033–46. April 2013. doi:10.2337/dc12-2625.
PMC 3609540 . PMID 23468086.
^ Cooke DW, Plotnick L (November 2008). "Type 1 diabetes mellitus in
pediatrics". Pediatrics in Review. 29 (11): 374–84; quiz 385.
doi:10.1542/pir.29-11-374. PMID 18977856.
^ Rockefeller, J. D. (2015-06-18). Diabetes: Symptoms, Causes,
Treatment and Prevention. ISBN 9781514603055. Archived from the
original on 2017-09-06.
^ Kenny C (April 2014). "When hypoglycemia is not obvious: diagnosing
and treating under-recognized and undisclosed hypoglycemia". Primary
Care Diabetes. 8 (1): 3–11. doi:10.1016/j.pcd.2013.09.002.
^ Verrotti A, Scaparrotta A, Olivieri C, Chiarelli F (December 2012).
"Seizures and type 1 diabetes mellitus: current state of knowledge".
European Journal of Endocrinology. 167 (6): 749–58.
doi:10.1530/EJE-12-0699. PMID 22956556. Archived from the
original on 2014-11-07.
^ Hsieh, Arthur. "Drunk versus diabetes: How can you tell?". Archived
from the original on 13 July 2016. Retrieved 29 June 2016.
^ "Symptoms of Low Blood Sugar". WebMD. Archived from the original on
18 June 2016. Retrieved 29 June 2016.
^ "GLUCAGON - INJECTION (Glucagon) side effects, medical uses, and
drug interactions". MedicineNet. Retrieved 2018-02-05.
^ a b Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN (July 2009).
"Hyperglycemic crises in adult patients with diabetes". Diabetes Care.
32 (7): 1335–43. doi:10.2337/dc09-9032. PMC 2699725 .
PMID 19564476. Archived from the original on 2016-06-25.
^ Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E,
Ingelsson E, Lawlor DA, Selvin E, Stampfer M, Stehouwer CD, Lewington
S, Pennells L, Thompson A, Sattar N, White IR, Ray KK, Danesh J (June
2010). "Diabetes mellitus, fasting blood glucose concentration, and
risk of vascular disease: a collaborative meta-analysis of 102
prospective studies". Lancet. 375 (9733): 2215–22.
doi:10.1016/S0140-6736(10)60484-9. PMC 2904878 .
^ O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA,
Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz
HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ,
Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL,
Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D,
Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG,
Yancy CW (January 2013). "2013 ACCF/AHA guideline for the management
of ST-elevation myocardial infarction: a report of the American
College of Cardiology Foundation/American Heart Association Task Force
on Practice Guidelines". Circulation. 127 (4): e362–425.
doi:10.1161/CIR.0b013e3182742cf6. PMID 23247304.
^ a b c d "Diabetes Programme". World Health Organization. Archived
from the original on 26 April 2014. Retrieved 22 April 2014.
^ "Diabetes - eye care:
MedlinePlus Medical Encyclopedia".
medlineplus.gov. Retrieved 2018-03-27.
^ Cukierman, T (8 Nov 2005). "Cognitive decline and dementia in
diabetes – systematic overview of prospective observational
studies". Springer-Verlag. doi:10.1007/s00125-005-0023-4/fulltext.html
(inactive 2018-01-25). Retrieved 28 Apr 2013.
^ Yang Y, Hu X, Zhang Q, Zou R (November 2016). "
Diabetes mellitus and
risk of falls in older adults: a systematic review and meta-analysis".
Age and Ageing. 45 (6): 761–767. doi:10.1093/ageing/afw140.
^ Lambert P, Bingley PJ (2002). "What is Type 1 Diabetes?". Medicine.
30: 1–5. doi:10.1383/medc.18.104.22.168264.
^ Tuomi T, Santoro N, Caprio S, Cai M, Weng J, Groop L (March 2014).
"The many faces of diabetes: a disease with increasing heterogeneity".
Lancet. 383 (9922): 1084–94. doi:10.1016/S0140-6736(13)62219-9.
^ Rother KI (April 2007). "Diabetes treatment--bridging the divide".
The New England Journal of Medicine. 356 (15): 1499–501.
doi:10.1056/NEJMp078030. PMC 4152979 .
^ a b "Diabetes Mellitus (DM): Diabetes Mellitus and Disorders of
Carbohydrate Metabolism: Merck Manual Professional". Merck Publishing.
April 2010. Archived from the original on 2010-07-28. Retrieved
^ Dorner M, Pinget M, Brogard JM (May 1977). "[Essential labile
diabetes (author's transl)]". MMW, Munchener Medizinische
Wochenschrift (in German). 119 (19): 671–4. PMID 406527.
^ a b Petzold A, Solimena M, Knoch KP (October 2015). "Mechanisms of
Beta Cell Dysfunction Associated With Viral Infection". Current
Diabetes Reports (Review). 15 (10): 73. doi:10.1007/s11892-015-0654-x.
PMC 4539350 . PMID 26280364. So far, none of the
hypotheses accounting for virus-induced beta cell autoimmunity has
been supported by stringent evidence in humans, and the involvement of
several mechanisms rather than just one is also plausible.
^ Butalia S, Kaplan GG, Khokhar B, Rabi DM (December 2016).
"Environmental Risk Factors and Type 1 Diabetes: Past, Present, and
Future". Canadian Journal of Diabetes (Review). 40 (6): 586–593.
doi:10.1016/j.jcjd.2016.05.002. PMID 27545597.
^ Serena G, Camhi S, Sturgeon C, Yan S, Fasano A (August 2015). "The
Gluten in Celiac Disease and Type 1 Diabetes". Nutrients. 7
(9): 7143–62. doi:10.3390/nu7095329. PMC 4586524 .
^ Visser J, Rozing J, Sapone A, Lammers K, Fasano A (May 2009). "Tight
junctions, intestinal permeability, and autoimmunity: celiac disease
and type 1 diabetes paradigms". Annals of the New York Academy of
Sciences. 1165: 195–205. Bibcode:2009NYASA1165..195V.
doi:10.1111/j.1749-6632.2009.04037.x. PMC 2886850 .
^ a b Risérus U, Willett WC, Hu FB (January 2009). "Dietary fats and
prevention of type 2 diabetes". Progress in Lipid Research. 48 (1):
44–51. doi:10.1016/j.plipres.2008.10.002. PMC 2654180 .
^ Malik VS, Popkin BM, Bray GA, Després JP, Hu FB (March 2010).
"Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and
cardiovascular disease risk". Circulation. 121 (11): 1356–64.
doi:10.1161/CIRCULATIONAHA.109.876185. PMC 2862465 .
^ Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB
(November 2010). "Sugar-sweetened beverages and risk of metabolic
syndrome and type 2 diabetes: a meta-analysis". Diabetes Care. 33
(11): 2477–83. doi:10.2337/dc10-1079. PMC 2963518 .
^ Hu EA, Pan A, Malik V, Sun Q (March 2012). "
White rice consumption
and risk of type 2 diabetes: meta-analysis and systematic review".
BMJ. 344: e1454. doi:10.1136/bmj.e1454. PMC 3307808 .
^ Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT (July
2012). "Effect of physical inactivity on major non-communicable
diseases worldwide: an analysis of burden of disease and life
expectancy". Lancet. 380 (9838): 219–29.
doi:10.1016/S0140-6736(12)61031-9. PMC 3645500 .
^ a b "National Diabetes Clearinghouse (NDIC): National Diabetes
Statistics 2011". U.S. Department of Health and Human Services.
Archived from the original on 17 April 2014. Retrieved 22 April
^ "Monogenic Forms of Diabetes". National institute of diabetes and
digestive and kidney diseases. US NIH. Archived from the original on
12 March 2017. Retrieved 12 March 2017.
^ a b "Definition, Diagnosis and Classification of Diabetes Mellitus
and its Complications" (PDF). World Health Organisation. 1999.
Archived (PDF) from the original on 2003-03-08.
^ de la Monte SM (December 2014). "Type 3 diabetes is sporadic
Alzheimer׳s disease: mini-review". European Neuropsychopharmacology.
24 (12): 1954–60. doi:10.1016/j.euroneuro.2014.06.008.
PMC 4444430 . PMID 25088942.
^ Unless otherwise specified, reference is: Table 20-5 in Mitchell,
Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.
Robbins Basic Pathology (8th ed.). Philadelphia: Saunders.
^ Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ,
Seshasai SR, McMurray JJ, Freeman DJ, Jukema JW, Macfarlane PW,
Packard CJ, Stott DJ, Westendorp RG, Shepherd J, Davis BR, Pressel SL,
Marchioli R, Marfisi RM, Maggioni AP, Tavazzi L, Tognoni G, Kjekshus
J, Pedersen TR, Cook TJ, Gotto AM, Clearfield MB, Downs JR, Nakamura
H, Ohashi Y, Mizuno K, Ray KK, Ford I (February 2010). "
risk of incident diabetes: a collaborative meta-analysis of randomised
statin trials". Lancet. 375 (9716): 735–42.
doi:10.1016/S0140-6736(09)61965-6. PMID 20167359.
^ Ahlqvist, Emma; Storm, Petter; Käräjämäki, Annemari; Martinell,
Mats; Dorkhan, Mozhgan; Carlsson, Annelie; Vikman, Petter; Prasad,
Rashmi B; Aly, Dina Mansour. "Novel subgroups of adult-onset diabetes
and their association with outcomes: a data-driven cluster analysis of
six variables". The Lancet Diabetes & Endocrinology. 0 (0).
doi:10.1016/S2213-8587(18)30051-2. ISSN 2213-8587.
^ Davis, Nicola (2018-03-01). "Five categories for adult diabetes, not
just type 1 and type 2, study shows". the Guardian. Retrieved
Insulin Basics". American Diabetes Association. Archived from the
original on 14 February 2014. Retrieved 24 April 2014.
^ a b c d Shoback DG, Gardner D, eds. (2011). Greenspan's basic &
clinical endocrinology (9th ed.). McGraw-Hill Medical.
^ Barrett KE, et al. (2012). Ganong's review of medical physiology
(24th ed.). McGraw-Hill Medical. ISBN 0071780033.
^ Murray RK, et al. (2012). Harper's illustrated biochemistry (29th
ed.). McGraw-Hill Medical. ISBN 007176576X.
^ Definition and diagnosis of diabetes mellitus and intermediate
hyperglycemia: report of a WHO/IDF consultation (PDF). Geneva: World
Health Organization. 2006. p. 21.
^ Vijan, S (March 2010). "Type 2 diabetes". Annals of Internal
Medicine. 152 (5): ITC31-15.
doi:10.7326/0003-4819-152-5-201003020-01003. PMID 20194231.
^ ""Diabetes Care" January 2010". American Diabetes Association.
Archived from the original on 13 January 2010. Retrieved 29 January
^ Saydah SH, Miret M, Sung J, Varas C, Gause D, Brancati FL (August
2001). "Postchallenge hyperglycemia and mortality in a national sample
of U.S. adults". Diabetes Care. 24 (8): 1397–402.
doi:10.2337/diacare.24.8.1397. PMID 11473076.
^ Definition and diagnosis of diabetes mellitus and intermediate
hyperglycemia : report of a WHO/IDF consultation (PDF). World
Health Organization. 2006. p. 21. ISBN 978-92-4-159493-6.
Archived (PDF) from the original on 11 May 2012.
^ Santaguida PL, Balion C, Hunt D, Morrison K, Gerstein H, Raina P,
Booker L, Yazdi H. "Diagnosis, Prognosis, and Treatment of Impaired
Glucose Tolerance and Impaired Fasting Glucose". Summary of Evidence
Report/Technology Assessment, No. 128. Agency for Healthcare Research
and Quality. Archived from the original on 16 September 2008.
Retrieved 20 July 2008.
^ Bartoli E, Fra GP, Carnevale Schianca GP (February 2011). "The oral
glucose tolerance test (OGTT) revisited". European Journal of Internal
Medicine. 22 (1): 8–12. doi:10.1016/j.ejim.2010.07.008.
^ Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J,
Coresh J, Brancati FL (March 2010). "Glycated hemoglobin, diabetes,
and cardiovascular risk in nondiabetic adults". The New England
Journal of Medicine. 362 (9): 800–11. doi:10.1056/NEJMoa0908359.
PMC 2872990 . PMID 20200384.
^ Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K,
Veerman JL, Delwiche K, Iannarone ML, Moyer ML, Cercy K, Vos T, Murray
CJ, Forouzanfar MH (August 2016). "
Physical activity and risk of
breast cancer, colon cancer, diabetes, ischemic heart disease, and
ischemic stroke events: systematic review and dose-response
meta-analysis for the Global Burden of Disease Study 2013". BMJ. 354:
i3857. doi:10.1136/bmj.i3857. PMC 4979358 .
^ a b "The
Nutrition Source". Harvard School of Public Health.
Archived from the original on 25 April 2014. Retrieved 24 April
^ Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J (December 2007).
"Active smoking and the risk of type 2 diabetes: a systematic review
and meta-analysis". JAMA. 298 (22): 2654–64.
doi:10.1001/jama.298.22.2654. PMID 18073361.
^ World Health Organization, Chronic diseases and their common risk
factors. Archived 2016-10-17 at the Wayback Machine. Geneva, 2005.
Accessed 30 August 2016.
^ No cure for diabetes Archived 2015-05-21 at the Wayback Machine.
(Retrieved May 2015, WebMD website)
^ Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ,
Raskin P, Zinman B (December 2005). "Intensive diabetes treatment and
cardiovascular disease in patients with type 1 diabetes". The New
England Journal of Medicine. 353 (25): 2643–53.
doi:10.1056/NEJMoa052187. PMC 2637991 .
^ "The effect of intensive diabetes therapy on the development and
progression of neuropathy. The Diabetes Control and Complications
Trial Research Group". Annals of Internal Medicine. 122 (8): 561–8.
April 1995. doi:10.7326/0003-4819-122-8-199504150-00001.
^ a b National Institute for Health and Clinical Excellence. Clinical
guideline 66: Type 2 diabetes. London, 2008.
^ Cavanagh PR (2004). "Therapeutic footwear for people with diabetes".
Diabetes/Metabolism Research and Reviews. 20 Suppl 1 (Suppl 1):
S51–5. doi:10.1002/dmrr.435. PMID 15150815.
^ Haw JS, Galaviz KI, Straus AN, Kowalski AJ, Magee MJ, Weber MB, Wei
J, Narayan KM, Ali MK (December 2017). "Long-term Sustainability of
Diabetes Prevention Approaches: A Systematic Review and Meta-analysis
of Randomized Clinical Trials". JAMA Internal Medicine. 177 (12):
^ Mottalib A, Kasetty M, Mar JY, Elseaidy T, Ashrafzadeh S, Hamdy O
(August 2017). "Weight Management in Patients with Type 1 Diabetes and
Obesity". Current Diabetes Reports. 17 (10): 92.
doi:10.1007/s11892-017-0918-8. PMC 5569154 .
^ Emadian A, Andrews RC, England CY, Wallace V, Thompson JL (November
2015). "The effect of macronutrients on glycaemic control: a
systematic review of dietary randomised controlled trials in
overweight and obese adults with type 2 diabetes in which there was no
difference in weight loss between treatment groups". The British
Journal of Nutrition. 114 (10): 1656–66.
doi:10.1017/S0007114515003475. PMC 4657029 .
^ Grams J, Garvey WT (June 2015). "Weight Loss and the Prevention and
Treatment of Type 2 Diabetes Using Lifestyle Therapy, Pharmacotherapy,
and Bariatric Surgery: Mechanisms of Action". Current
4 (2): 287–302. doi:10.1007/s13679-015-0155-x.
^ a b Krentz AJ, Bailey CJ (2005). "Oral antidiabetic agents: current
role in type 2 diabetes mellitus". Drugs. 65 (3): 385–411.
doi:10.2165/00003495-200565030-00005. PMID 15669880.
^ Consumer Reports;
American College of Physicians
American College of Physicians (April 2012),
"Choosing a type 2 diabetes drug – Why the best first choice is
often the oldest drug" (PDF), High Value Care, Consumer Reports,
archived (PDF) from the original on July 2, 2014, retrieved August 14,
^ Nelson, Mark. "Drug treatment of elevated blood pressure".
Australian Prescriber (33): 108–12. Archived from the original on 26
August 2010. Retrieved 11 August 2010.
^ Arguedas JA, Perez MI, Wright JM (July 2009). Arguedas JA, ed.
"Treatment blood pressure targets for hypertension". The Cochrane
Database of Systematic Reviews (3): CD004349.
doi:10.1002/14651858.CD004349.pub2. PMID 19588353.
^ Arguedas JA, Leiva V, Wright JM (October 2013). "Blood pressure
targets for hypertension in people with diabetes mellitus". The
Cochrane Database of Systematic Reviews. 10 (10): CD008277.
doi:10.1002/14651858.cd008277.pub2. PMID 24170669.
^ Brunström M, Carlberg B (February 2016). "Effect of
antihypertensive treatment at different blood pressure levels in
patients with diabetes mellitus: systematic review and meta-analyses".
BMJ. 352: i717. doi:10.1136/bmj.i717. PMC 4770818 .
^ Cheng J, Zhang W, Zhang X, Han F, Li X, He X, Li Q, Chen J (May
2014). "Effect of angiotensin-converting enzyme inhibitors and
angiotensin II receptor blockers on all-cause mortality,
cardiovascular deaths, and cardiovascular events in patients with
diabetes mellitus: a meta-analysis". JAMA Internal Medicine. 174 (5):
^ Pignone M, Alberts MJ, Colwell JA, Cushman M, Inzucchi SE, Mukherjee
D, Rosenson RS, Williams CD, Wilson PW, Kirkman MS (June 2010).
Aspirin for primary prevention of cardiovascular events in people
with diabetes: a position statement of the American Diabetes
Association, a scientific statement of the American Heart Association,
and an expert consensus document of the American College of Cardiology
Foundation". Diabetes Care. 33 (6): 1395–402. doi:10.2337/dc10-0555.
PMC 2875463 . PMID 20508233.
^ Frachetti KJ, Goldfine AB (April 2009). "
Bariatric surgery for
diabetes management". Current Opinion in Endocrinology, Diabetes and
Obesity. 16 (2): 119–24. doi:10.1097/MED.0b013e32832912e7.
^ a b Schulman AP, del Genio F, Sinha N, Rubino F (September–October
2009). ""Metabolic" surgery for treatment of type 2 diabetes
mellitus". Endocrine Practice. 15 (6): 624–31.
doi:10.4158/EP09170.RAR. PMID 19625245.
^ Colucci RA (January 2011). "
Bariatric surgery in patients with type
2 diabetes: a viable option". Postgraduate Medicine. 123 (1): 24–33.
doi:10.3810/pgm.2011.01.2242. PMID 21293081.
^ Dixon JB, le Roux CW, Rubino F, Zimmet P (June 2012). "Bariatric
surgery for type 2 diabetes". Lancet. 379 (9833): 2300–11.
doi:10.1016/S0140-6736(12)60401-2. PMID 22683132.
Pancreas Transplantation". American Diabetes Association. Archived
from the original on 13 April 2014. Retrieved 9 April 2014.
^ Polisena J, Tran K, Cimon K, Hutton B, McGill S, Palmer K (October
2009). "Home telehealth for diabetes management: a systematic review
and meta-analysis". Diabetes,
Obesity & Metabolism. 11 (10):
^ a b c d e f g World Health Organization, Global Report on Diabetes.
^ Gale EA, Gillespie KM (January 2001). "Diabetes and gender".
Diabetologia. 44 (1): 3–15. doi:10.1007/s001250051573.
^ Meisinger C, Thorand B, Schneider A, et al. (2002). "Sex differences
in risk factors for incident type 2 Diabetes Mellitus: The MONICA
Augsburg Cohort Study". JAMA Internal Medicine. 162 (1): 82–89.
^ Public Health Agency of Canada, Diabetes in Canada: Facts and
figures from a public health perspective. Ottawa, 2011.
^ Mathers CD, Loncar D (November 2006). "Projections of global
mortality and burden of disease from 2002 to 2030". PLoS Medicine. 3
(11): e442. doi:10.1371/journal.pmed.0030442. PMC 1664601 .
^ a b Wild S, Roglic G, Green A, Sicree R, King H (May 2004). "Global
prevalence of diabetes: estimates for the year 2000 and projections
for 2030". Diabetes Care. 27 (5): 1047–53.
doi:10.2337/diacare.27.5.1047. PMID 15111519.
^ Ripoll, Brian C. Leutholtz, Ignacio (2011-04-25).
disease management (2nd ed.). Boca Raton: CRC Press. p. 25.
ISBN 978-1-4398-2759-8. Archived from the original on
^ a b c d e f g h i editor, Leonid Poretsky, (2009). Principles of
diabetes mellitus (2nd ed.). New York: Springer. p. 3.
ISBN 978-0-387-09840-1. Archived from the original on
^ a b Roberts, Jacob (2015). "Sickening sweet". Distillations. 1 (4):
12–15. Retrieved 20 March 2018.
^ a b Laios K, Karamanou M, Saridaki Z, Androutsos G (2012). "Aretaeus
of Cappadocia and the first description of diabetes" (PDF). Hormones.
11 (1): 109–13. PMID 22450352. Archived (PDF) from the original
^ a b Oxford English Dictionary. diabetes. Retrieved 2011-06-10.
^ a b Harper, Douglas (2001–2010). "Online Etymology Dictionary.
diabetes.". Archived from the original on 2012-01-13. Retrieved
^ Aretaeus, De causis et signis acutorum morborum (lib. 2), Κεφ.
β. περὶ Διαβήτεω (Chapter 2, On Diabetes, Greek original
Archived 2014-07-02 at the Wayback Machine., on Perseus
^ a b c d Oxford English Dictionary. mellite. Retrieved 2011-06-10.
^ a b c d "MyEtimology. mellitus.". Archived from the original on
2011-03-16. Retrieved 2011-06-10.
^ Oxford English Dictionary. -ite. Retrieved 2011-06-10.
^ Theodore H. Tulchinsky, Elena A. Varavikova (2008). The New Public
Health, Second Edition. New York: Academic Press. p. 200.
^ Piwernetz K, Home PD, Snorgaard O, Antsiferov M, Staehr-Johansen K,
Krans M (May 1993). "Monitoring the targets of the St Vincent
Declaration and the implementation of quality management in diabetes
care: the DIABCARE initiative. The DIABCARE Monitoring Group of the St
Vincent Declaration Steering Committee". Diabetic Medicine. 10 (4):
^ Dubois H, Bankauskaite V (2005). "Type 2 diabetes programmes in
Europe" (PDF). Euro Observer. 7 (2): 5–6. Archived (PDF) from the
original on 2012-10-24.
^ Stewart WF, Ricci JA, Chee E, Hirsch AG, Brandenburg NA (June 2007).
"Lost productive time and costs due to diabetes and diabetic
neuropathic pain in the US workforce". Journal of Occupational and
Environmental Medicine. 49 (6): 672–9.
doi:10.1097/JOM.0b013e318065b83a. PMID 17563611.
^ Washington R.E.; Andrews R.M.; Mutter R.L. (November 2013).
"Emergency Department Visits for Adults with Diabetes, 2010". HCUP
Statistical Brief #167. Rockville MD: Agency for Healthcare Research
and Quality. Archived from the original on 2013-12-03.
^ Parker, Katrina (2008). Living with diabetes. New York: Facts On
File. p. 143. ISBN 9781438121086. Archived from the original
^ a b "Diabetes mellitus". Merck Veterinary Manual, 9th edition
(online version). 2005. Archived from the original on 2011-09-27.
^ Öhlund, Malin. Feline diabetes mellitus Aspects on epidemiology and
pathogenesis (PDF). Acta Universitatis agriculturae Sueciae.
^ a b Maria Rotella C, Pala L, Mannucci E (Summer 2013). "Role of
insulin in the type 2 diabetes therapy: past, present and future".
International Journal of
Endocrinology and Metabolism. 11 (3):
137–44. doi:10.5812/ijem.7551. PMC 3860110 .
^ "Press Announcement". FDA. Archived from the original on 3 March
2016. Retrieved 11 February 2016.
Insulin Clears Hurdle Toward F.D.A. Approval". New York
Times. Archived from the original on 7 April 2014. Retrieved 12 April
^ in-PharmaTechnologist.com. "World's first transdermal insulin shows
promise". Archived from the original on 2015-05-01. Retrieved
^ "Phosphagenics Initiates Trial of Transdermal
www.fdanews.com. Archived from the original on 2016-08-18. Retrieved
Polonsky KS (October 2012). "The past 200 years in diabetes". The New
England Journal of Medicine. 367 (14): 1332–40.
doi:10.1056/NEJMra1110560. PMID 23034021.
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Diabetes mellitus at Curlie (based on DMOZ)
IDF Diabetes Atlas
National Diabetes Education Program
Diseases of the endocrine system (E00–E35, 240–259)
MODY 1 2 3 4 5 6
insulin receptor (Rabson–Mendenhall syndrome)
beta cell (Hyperinsulinism)
G cell (Zollinger–Ellison syndrome)
CRH (Tertiary adrenal insufficiency)
vasopressin (Neurogenic diabetes insipidus)
Pituitary ACTH hypersecretion
general (Nelson's syndrome)
Growth hormone deficiency
ACTH deficiency/Secondary adrenal insufficiency
posterior (Neurogenic diabetes insipidus)
Empty sella syndrome
Euthyroid sick syndrome
Thyroid hormone resistance
Familial dysalbuminemic hyperthyroxinemia
Toxic nodular goitre
Toxic multinodular goiter
Osteitis fibrosa cystica
aldosterone: Hyperaldosteronism/Primary aldosteronism
Glucocorticoid remediable aldosteronism
Cushing's syndrome (Pseudo-Cushing's syndrome)
sex hormones: 21α CAH
sex hormones: 17α CAH
ovarian: Polycystic ovary syndrome
Premature ovarian failure
17β-hydroxysteroid dehydrogenase deficiency
aromatase excess syndrome
Androgen receptor (Androgen insensitivity syndrome)
Hypogonadism (Delayed puberty)
Postorgasmic illness syndrome
Autoimmune polyendocrine syndrome multiple
Multiple endocrine neoplasia
Diabetes (E10–E14, 250)
Diabetes and pregnancy
Impaired fasting glucose
Impaired glucose tolerance
Type 3c (Pancreatogenic)
Blood sugar level
Glucose tolerance test
Postprandial glucose test
Noninvasive glucose monitor
Insulin tolerance test
Embryonic stem cells
Gastric bypass surgery
Hyperosmolar hyperglycemic state
Organs in diabetes
Diabetic skin disease
Glossary of diabetes
Notable people with type 1 diabetes