Diabetes Mellitus - Type 1 & 2

A disorder caused as a result of insufficient or inability to produce the hormone insulin by the pancreas. Insulin is an important hormone responsible for the absorption of glucose into cells for energy needs and into the liver fat cells for storage. Deficiency of insulin causes the glucose levels to increase abnormally high, causing polyuria (passing of quantities of urine) and polydipsia (excessive thirst). Weight loss occurs as the body is unable to store or utilise glucose this in turn causes us to feel hunger and fatigue. Diabetes mellitus causes disordered lipid metabolism and degeneration of small blood vessels.

There two main types of diabetes type 1 and II. Type 1 general affects the younger age group and is the most serve of the 2 in which the patient becomes dependent on insulin. In this patient the insulin secreting cell in pancreas are destroyed. Type II is a non insulin dependent affecting people over 40. In the person the insulin is produced but not enough to meet the demand especially when the person is over weight.

Some characteristics changes on Body Composition in depending on the type of Diabetes i.e. Type 1 or II

  Higher body Fat in type II diabetes (obesity)
  Depending on the diabetes type low or high FFM
  Weight gain or loss depends on the type of diabetes
  Type 1 diabetes Bone Mineral loss
  Type 2 diabetes Higher Bone Mass and Mineral density
  Change in Body Composition


Monitoring Body Composition

Many complications can eventually develop in diabetes population, therefore monitoring body composition changes over time in this population is important. What has been shown in type 1 diabetes patients Fat Free Mass is similar or slightly higher compared to healthy population although the body weight and Fat Mass was lower than ideal weight and healthy group. What was been noticed with the introduction of insulin therapy Body Weight, Fat Mass and Fat Free Mass increases. Bone Mineral loss and osteoporosis occurs in diabetes person.

The body composition of the person with type II diabetes is different they tend to be over weight or obese in some cases with higher then average abdominal fat compared to patients with type 1 diabetes. Type II diabetes person will have a higher Bone Mass and Bone mineral density.

Body composition assessment is an important indicator which should be assessed regular in diabetes population.

TECHNICAL PAPERS

Bjorntorp, P. (1988). Abdominal obesity and the development of non-insulin diabetes mellitus. Diabetes and Metabolism Reviews, 4, 615-622.

Carter Centre of Emory University. (1985). Closing the gap: The problem of diabetes mellitus in the United States. Diabetes Care, 8, 391-406.

Gregory J W, Wilson A C, Greene S A. Body fat and overweight among children and adolescents with diabetes mellitus. Diabet-Med. 1992; May, 9(4): 344-8

Haffner, S.M., Stern, M.P., Mitchell, B.D., Hazuda, H.P., & Patterson, J.K. (1990). Incidence of type 11 diabetes in Mexican-Americans predicted by fasting insulin and glucose levels, obesity, and body-fat distribution. Diabetes, 39, 283-288.

Inada C, Yamada K, Nakao H, Otabe S, Nonaka K. Estimation of body fat bioelectrical impedance analysis in diabetic patients. In: Mimura G, Chi Z, editors. Recent progress of diabetes mellitus in East Asia; 3rd Japan-China Symposium on Diabetes Mellitus; 1991 Oct; Shanghai, China. New York: Excerpta Medica; 1992. p. 199-204. (International congress series; no. 997).

Jovanovic-Peterson L, Crues J, Durak E, Peterson CM. Magnetic resonance imaging in pregnancies complicated by gestational diabetes predicts infant birth weight ratio and neonatal morbidity. Am J Perinatol 1993 Nov;10(6) :432-7.

Knowler, W.C., Pettitt, D.J., Savage, P.J., Bennett, P.H. (1981). Diabetes incidence in Pima Indians: Contributions of obesity and parental diabetes. American Journal of Epidemiology, 113, 144-156.

Osei K, Cottrell D A, Orabella M M. Insulin sensitivity, glucose effectiveness, and body fat distribution pattern in nondiabetic offspring of patients with NIDDM. Diabetes-Cane. 1991; Oct, 14(10): 890-6

Samet, J.M., Coultas, D.B., Howard, C.A., Skipper, B.J., & Hanis, C.L. (1988). Diabetes, gallbladder disease, obesity, and hypertension among Hispanics in New Mexico. American Journal of Epidemiology, 128, 1302-1311.

Yeager, K.K., Agostini, R., Nattiv, A., & Drinkwater, B. (1993). The female athlete triad: Disordered eating, amenorrhea, osteoporosis. Medicine and Science in Sports and Exercise, 25, 775-777.