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Readers who wish to comment on the Standards of Care are invited to do so at professional. Specific types of diabetes due to other causes, e. Gestational diabetes mellitus diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes prior to gestation. This section reviews most common forms of diabetes but is not comprehensive. Type 1 diabetes and type 2 diabetes are heterogeneous diseases in which clinical presentation and disease progression may vary considerably.
Classification is important for determining therapy, but some individuals cannot be clearly classified as having type 1 or type 2 diabetes at the time of diagnosis. The traditional paradigms of type 2 diabetes occurring only in adults and type 1 diabetes only in children are no longer accurate, as both diseases occur in both age-groups.
The onset of type 1 diabetes may be more variable in adults; they may not present with the classic symptoms seen in children and may experience temporary remission from the need for insulin 5 — 7. Occasionally, patients with type 2 diabetes may present with DKA 9 , 10 , particularly ethnic and racial minorities It is important for the provider to realize that classification of diabetes type is not always straightforward at presentation and that misdiagnosis is common e.
Once hyperglycemia occurs, people with all forms of diabetes are at risk for developing the same chronic complications, although rates of progression may differ. Across the globe many groups are working on combining clinical, pathophysiological, and genetic characteristics to more precisely define the subsets of diabetes that are currently clustered into the type 1 diabetes versus type 2 diabetes nomenclature with the goal of optimizing personalized treatment approaches.
