Insulin-Dependent Diabetes Mellitus

Insulin-Dependent Diabetes Mellitus (IDDM) is an autoimmune condition resulting from the destruction of the cells of theIslets of Langerhans that produce insulin. Because there is no insulin patients are unable to absorb and metabolise glucose. This means that the levels of glucose in the blood get high - a condition called hyperglycaemia. The high glucose gets filtered through the kidneys, and takes with it a lot of water. This means that the patient passes a lot of urine (the word diabetes means "a siphoning forth") which contains high levels of sugar and is sweet (and therefore called diabetes mellitus, rather than diabetes insipidus, where the urine is very dilute).

Because they pass a lot of water, they are very thirsty, so they drink a lot - described as polyuria and polydypsia. Because they're not absorbing glucose they derive energy by breaking down their body fat, so they lose weight. Insulin is required, and the amount needed must be titrated carefully to control blood sugar and prevent the development of complications such as diabetic eye disease (see the eye section) or atherosclerosis (see the heart and circulation).

Careful attention to diet is mandatory. This is a genetically determined condition where some people are at risk of developing antibodies to their islet cells, and it accounts for about 15 per cent of the cases of diabetes mellitus in the UK, with the other 85 per cent being due to Non Insulin-Dependent Diabetes Mellitus (NIDDM). IDDM is also called juvenile onset diabetes, because it can start in infancy or adolescence, but it may also occur in adulthood. NIDDM was also called maturity onset diabetes, since it rarely occurred in young people, but it is now being seen in younger people as a result of an increase in obesity.
 
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