How many stages of diabetes are there
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Summary
10 papers analyzed
These studies suggest there are multiple stages of diabetes, commonly categorized into stages 1-5, with specific stages for type 1 diabetes, type 2 diabetes, and diabetic kidney disease.
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Stages of Diabetes: A Comprehensive Overview
Five Stages of Beta-Cell Dysfunction in Diabetes
Diabetes progression is marked by five distinct stages of beta-cell dysfunction.
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Compensation: In this initial stage, insulin secretion increases to maintain normal blood glucose levels despite insulin resistance or decreasing beta-cell mass. This stage is characterized by intact acute glucose-stimulated insulin secretion (GSIS).
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Beta-Cell Adaptation: As glucose levels rise to approximately 5.0-6.5 mmol/l, beta-cell mass decreases, and function is disrupted, leading to diminished GSIS and beta-cell dedifferentiation.
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Early Decompensation: This transient stage involves a rapid increase in glucose levels, leading to the onset of frank diabetes.
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Stable Decompensation: Characterized by more severe beta-cell dedifferentiation and stable high glucose levels.
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Severe Decompensation: Marked by a profound reduction in beta-cell mass and progression to ketosis.
Stages of Type 1 Diabetes
Type 1 diabetes (T1D) progresses through three identifiable stages before the onset of symptoms:
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Stage 1: Presence of beta-cell autoimmunity with normoglycemia and no symptoms .
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Stage 2: Beta-cell autoimmunity with dysglycemia, still presymptomatic .
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Stage 3: Onset of symptomatic disease .
Stages of Diabetic Renal Disease
Diabetic renal disease progresses through five stages:
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Early Hyperfunction and Hypertrophy: Found at diagnosis, characterized by increased urinary albumin excretion, which is reversible with insulin treatment.
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Silent Morphologic Lesions: Develops over years with increased GFR and albumin excretion during poor diabetes control.
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Incipient Diabetic Nephropathy: Elevated urinary albumin excretion and rising blood pressure.
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Overt Diabetic Nephropathy: Persistent proteinuria and declining renal function.
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End-Stage Renal Failure: Uremia due to diabetic nephropathy.
WHO Clinical Stages of Diabetes
The World Health Organization (WHO) classifies diabetes into three clinical stages:
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Non-Insulin Requiring (NIR): Patients manage with diet and/or oral antidiabetic agents.
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Insulin Requiring for Control (IRC): Patients need insulin therapy after one year due to deteriorating hyperglycemia.
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Insulin Requiring for Survival (IRS): Patients require insulin within one year to manage severe hyperglycemia .
Developmental Stages in Pediatric Diabetes
Children with diabetes face unique challenges at different developmental stages:
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Infancy (0-2 years): Managing diabetes in very young children.
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Toddlers and Preschoolers (2-5 years): Addressing the needs of young children with diabetes.
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School-Age Children (6-11 years): Balancing diabetes management with school activities.
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Adolescence (12-16 years): Navigating diabetes during the teenage years.
Stages of Type 2 Diabetes Development
Type 2 diabetes progresses through several stages, influenced by insulin resistance and insulin secretory dysfunction:
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Normal Glucose Tolerance (NGT): Initial stage with normal glucose levels.
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Impaired Glucose Tolerance (IGT): Intermediate stage with elevated glucose levels.
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Diabetes: Final stage with significantly high glucose levels.
Conclusion
Diabetes is a complex disease with multiple stages, each characterized by specific physiological changes. Understanding these stages helps in the early detection, management, and treatment of diabetes, ultimately improving patient outcomes.
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