**Identification and Monitoring of Diabetes Mellitus**

284 Type 1 Diabetes – Complications, Pathogenesis, and Alternative Treatments

Yabunaka, N.; Ohtsuka, Y.; Watanabe, I.; Noro, H.; Fujisawa, H. & Agishi, Y. (1995).

Zhang, Y.; Zou, Z.; Li, Y.K.; Yuan, H.B. & Shi, X.Y. (2009). Glutamine-induced heat shock

Ziegler, T.R.; Ogden, L.G.; Singleton, K.D.; Luo, M.; Fernandez-Estivariz, C.; Griffith, D.P.;

Zingarelli, B.& Cook, J.A. (2005). Peroxisome proliferator-activated receptor-gamma is a new therapeutic target in sepsis and inflammation. *Shock*, Vol. 23, N° 5, pp. 393-399

*Practice*, Vol. 30, N° 2, pp. 143-147

(Carlton), Vol. 14, N° 6, pp. 573-580

pp. 1079–1086

Elevated levels of heat-shock protein 70 (HSP70) in the mononuclear cells of patients with non-insulin-dependent diabetes mellitus. *Diabetes Research and Clinical* 

protein protects against renal ischaemia-reperfusion injury in rats. *Nephrology*

Galloway, J.R. & Wischmeyer, P.E. (2005). Parenteral glutamine increases serum heat shock protein 70 in critically ill patients. *Intensive Care Medicine*, Vol. 31, N° 8,

**14** 

*Uruguay* 

**Diabetes Type 1 and 2:** 

Adriana Mimbacas1 and Gerardo Javiel2,3

*Department of Genetics, Human Genetic Group 2ASSE-Ministry of Health, Hospital Pasteur* 

*3IAMPP-Centro de Asistencia del Sindicato Médico del Uruguay,(CASMU), Diabetologic Service* 

**What is Behind a Classification?** 

*1Instituto de Investigaciones Biológicas Clemente Estable,* 

At present, we wonder if the current classification of diabetes agrees with the new advances At the molecular genetic level. Every day we can see an exponential increase of type 1 and 2 diabetes anywhere in the world. On the other hand, although several clinical and biochemical characteristics have been described in order to differentiate between both types of diabetes, this does not seem satisfactory for all cases when facing the patient. These characteristics are: (a) The presence of a strong familiar history of diabetes, obesity, *acanthosis nigricans*, and lack of ketoacidosis and auto-antibodies against antigens of pancreatic b-cells islets supports the diagnosis of type 2 diabetes; (b) In contrast, patients with type 1 diabetes are usually thin and with ketoacidosis; almost 90% of them have auto-

Nevertheless, in the last decades numerous reports described adults and adolescents (usually from minority groups) presenting ketoacidosis with lack of antibodies and characteristics of type 2 diabetes such as obesity*, acanthosis nigricans* and/or one significant familiar history of diabetes (Pinhas-Hamiel et al., 1997; Pinhas-Hamiel &

Until very recently, most children and adolescents diagnosed with the disease were diagnosed as type 1 diabetes; however, there have recently been numerous reports describing an increase in the number of cases of type 2 diabetes in youngsters (Dabelea et al., 1998; Hathout et al., 2001; Neufeld et al., 1998; Pinhas Hamiel et al., 1996; Scott et al., 1997). Epidemiological data suggests that type 1 and 2 diabetes can coexist in the same

The potential importance of formulating a specific diagnosis has been emphasized, as this could determine the type of treatment, associated complications, and outcomes (Fagot et al., 2001; Pinhas-Hamiel & Zeitler, 1999). The current criteria for defining diabetes (Asociación Latinoamericana de Diabetes [ALAD], 2010; American Diabetes Association [ADA], 2010) do not always explain neither the evolution of the disease in different patients or the different responses of individuals to treatments. These facts are suggesting the importance

family (Kolb & Mandrup-Poulsen, 2005; Libman & Becker, 2003).

**1. Introduction** 

Zeitler, 1999;).

antibodies at the onset of the disease.
