Endocrine

Question 1

What are the differences in pathogenesis of Type 1 and Type 2 diabetes? What are the differences in clinical presentation of Type 1 and Type 2 diabetes?

Answer 1

1. Differences in pathogenesis
   A. Type 1
   - Genetic susceptibility
   - Autoimmunity with autoantibodies towards islet cells
   - Severe insulin deficiency
   - Islet cells insulitis, marked atrophy and severe B-cells depletion
   B. Type 2
   - Less genetic susceptibility
   - Increase insulin resistance
   - Relative insulin deficiency
   - Islet cells have NO INSULITIS, focal atrophy and mild B-cells depletion

2. Clinical presentation difference
A. Type 1
- Onset at younger age <20 yo
- Normal weight
- Diabetic ketoacidosis
- Very low insulin levels
- High autoantibodies
- 50% concordance in twins
B. Type 2
- Onset at later age
- Obese
- HONK and rarely ketoacidosis
- Normal or slightly low insulin levels
- No autoantibodies
- 90 - 100% concordance in twins