Unhealthy Heart

Much of the statistical analysis used to define diabetes has been derived from research on Caucasian communities. Much more data is needed from other parts of the world and from diverse racial groups because the presentation and response to diabetes treatment can be quite different around the world. Also, not everyone with diabetes fits neatly into the WHO classification system. Some patients share broadly similar characteristics that are not listed by the WHO. Some examples of these are presented below:

Insulin deficient Type 2.

There are some patients who have Type 2 diabetes but who are prone to episodes of severe insulin deficiency just as is seen in Type 1 diabetes. There are other Type 2 patients who have periodic insulin deficiency. On each such occasion the question of diagnosis will be raised because the presentation is just like that seen in Type 1 diabetes.

Autoantibody negative Type 1.

A significant number of patients classified as Type 1 will not demonstrate a positive antibody status. This raises doubt in the minds of patients about whether they actually have Type 1 diabetes. However the physician may focus at these times on prescribing appropriate treatment rather than classification. If insulin deficiency is obvious then insulin treatment will be the safest option no matter the type of the diabetes

Flatbush diabetes.

Named after an area in New York where this type of diabetes was first termed. The term describes a whole hotpot of different diagnostic scenarios in this group including the two types described above. There will be in between types such as those occasionally termed atypical Type 1B or idiopathic antibody negative Type 1. There will also be ketosis prone insulin deficient Type 2 patients.

Latent Autoimmune Diabetes of Adults (LADA):

This is a slow onset form of Type 1 diabetes that presents in adults.

Type 3 Diabetes.

Type 3 Diabetes is the term proposed by Brown University Medical School Professor Suzanne de la Monte for a form of insulin resistance or 'local diabetes' within the brain. The research suggests that the same dietary patterns contributing to obesity and Type 2 diabetes also cause parallel pathological changes in the brain leading to an increase incidence of dementia.

Specifically, Professor De La Monte has proposed that brain insulin resistance represents a key step in the progression to Alzheimer’s disease. At the present time most researchers believe that the cause of Alzheimer’s disease is multifactorial and not simple due to brain insulin resistance. The concept of Type 3 diabetes has not been included in the system of diabetes classification proposed either by the World Health Organization (WHO) or by the American Diabetes Association (ADA).

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