Differences between DM type 1 (juvenile diabetes), DM type 2, gestational diabetes, and diabetes insipidus

Differences between DM type 1 (juvenile diabetes), DM type 2, gestational diabetes, and diabetes insipidus

DM type 1 (juvenile diabetes), DM type 2, and gestational diabetes have problems emanating from the pancreas, unlike diabetes insipidus (DI). In DI, there is either a reduced response to antidiuretic hormone (ADH) or decreased release of antidiuretic hormone. The resultant effect is electrolyte imbalance. Moreover, there are two types of DI, notablycentral and nephrogenic diabetes, both have congenital and acquired causes (Chou et al., 2011).

DI is the only type of diabetes marked by the excessive passage of urine as the only feature. However, the most common type of DI is the idiopathic central DI. It is usually linked to defects in the vasopressin precursor synthesis and, hypothalamus malformation, and vasopressin deficiency(Chou et al., 2011). However, acquired forms of DI include ischemia or brain injury, surgery, trauma, sarcoidosis, autoimmune, vascular disease and Langerhans Cell Histiocytosis, metastasis, and structural malformations (Chou et al., 2011). Congenital forms of nephrogenic diabetes DI are linked to mutations in AVPR2 or AQP2 gene (Chou et al., 2011). 90% of nephrogenic genetic diabetes (congenital) is due to the AVPR2 receptor, and they are due to multiple drugs treatments, including lithium, antifungals, antibiotics, and antineoplastic agents. Other causes include renal disease, craniopharyngioma surgery, obstructive uropathy, electrolyte imbalance such as hypercalcemia and hypokalaemia.

DM type 1 or juvenile diabetes is caused by inadequate insulin production from the pancreas. It primarily affects children but can occur later in life. The leading cause of DM type 1 is an autoimmune disorder, where the beta cells undergo self-destruction, producing little or no insulin. Infections, especially viral infections, can also destroy the pancreas and lead to DM type 1. The patient complains of confusion, headache, excessive thirst, hunger and urination, fatigue, among other features. Most DM type 1 gets the hyperosmolar hyperglycaemic state with sugars more than 33mmols per liter. In such cases, the patient needs a lot of fluid to avoid getting into shock.

The best therapy for the patient is usually insulin injection. The patient needs to obtain artificial insulin, which comes in injection. The injection is given subcutaneously twice per day every in one’s lifetime.

The difference with DM type 2 is that in type 2, the insulin is always produced but in an inactive form. Moreover, it can be due to the insensitivity of the cells to insulin being reduced. Therefore, as opposed to type 1 DM, where insulin is given, oral hypoglycaemic agents are provided to sensitize the insulin produced.

Gestational diabetes occurs only during pregnancy. The term refers to an ordinary woman who did not have diabetes but acquired it when pregnant. However, this can lead to complications for the unborn child, such as big for gestational age, and the mother can have diabetes even after delivery.

Diabetes Mellitus type 2

Diabetes mellitus type 2 is the most common diabetes in the world. According to Kesavadev (2016), by 2015, 416 million people aged between 20 and 75 years had DM type 2. The disease usually begins with three cardinal features of polydipsia, polyuria, and polyphagia. Moreover, in the urine analysis, there is typically the presence of glucose in the urine. Most patients do not know that they have diabetes until they get the severe form of the disease (complications). Patients start to present with confusion, deep and increased breathing, and the production of a sweet fruity smell (a sign of ketones). The state is always called diabetic ketoacidosis, and it is at this stage, most of the patients will learn that they have diabetes.

Drug management and dietary recommendations

DM type 2 is managed through oral hypoglycaemic agents. There are different medications, but the commonly used drug is metformin, and it can be used singly or combined with other drugs such as glibenclamide. Metformin is a biguanide, and it comes in two different sizes, of 850 and 500 milligrams(Pourmatroud, 2019). Glibenclamide weighs only 5mg(Furman, 2017). They are taken twice a day, early in the morning and evening before bedtime. However, a physician prescribed the drugs after assessing the patient and understanding the need to provide the drug over another. The drug is administered orally and is stored in a cool and dry place.

Diet is essential when managing diabetes, and patients need to know the diet they need to prevent complications. A diet richin whole grains is the best instead of refined foods. The main reason i