Diabetes type I, II, Gestational Diabetes, and insipidus are the essential differences.
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Introduction
Diabetes is a common chronic condition that affects people of all ages. It occurs when blood
sugar is high (Marilyn Sawyer Sommers, 2022). The main signs and symptoms of diabetes are
polydipsia, polyuria, and polyphagia. There are different types of diabetes, the most common
being diabetes mellitus type I and II, gestational diabetes, and diabetes insipidus, as discussed
below.
Type I diabetes mellitus
Type 1 diabetes is mainly due to an autoimmune disorder that affects the pancreatic beta cells
that produce insulin. The exact cause of type I diabetes is not known. However, it is attributed to
an autoimmune disorder affecting the pancreatic islet cells that produce insulin (Marilyn Sawyer
Sommers, 2022). The destruction of pancreatic beta cells leads to less insulin production,
unchecked glucose production by the liver, and fasting blood sugar. Due to the lack of insulin,
glucose from food remains in the blood, leading to postprandial hyperglycemia. When glucose
exceeds the renal threshold, it is excreted in urine accompanied by large amounts of fluid and
electrolytes. Due to the lack of insulin to regulate gluconeogenesis and glycogenolysis,
hyperglycemia and fat breakdown produce ketone bodies that manifest as sweet breaths.
Someone with type I diabetes mellitus requires lifetime shots of insulin.
Type II diabetes
Most common type of diabetes. The body either has a decreased response to insulin effects or
less insulin is being produced; thus, less glucose is transported to the cells or both (Hinkle et al.,
2021). Type II diabetes is believed to be hereditary insulin resistance or abnormal insulin
production. Obesity, too, is attributed to insulin resistance. With insulin resistance and increased
blood glucose build-up, beta cells produce more insulin to transport glucose to cells. However,
with time, beta cells are overwhelmed by the insulin demand, leading to type II diabetes. This
type of diabetes goes unnoticed over the years as it develops slowly. Signs and symptoms are
usually mild. The three main symptoms are polydipsia, polyphagia, and polyuria. Polydipsia is
due to excess glucose in the blood. The body physiologically demands more water to help flush
out the sugar. At the same time, polyphagia increases appetite as less glucose is taken up by the
body cells to generate energy, which sends a signal to the brain of lack of glucose, increasing
hunger. Polyuria is excessive urine production due to high serum osmolarity; kidneys produce
more urine to excrete excess glucose in the blood. As insulin resistance is associated with
obesity, weight loss is key in managing type II diabetes. Dietary management and exercise can
significantly help in improving cell response to insulin. Elevated blood sugars are usually
managed with occasional shots of insulin.
Gestational diabetes
Gestational diabetes mellitus or insipidus develops during pregnancy and affects women who
have never had diabetes before. Usually goes away after delivery and is diagnosed between 24-
28 weeks gestation (Hinkle et al., 2021). It might develop into type II diabetes in some women.
Most physicians manage it with desmopressin when uncontrolled leads to macrosomia.
Diabetes insipidus
Diabetes insipidus has nothing to do with insulin or blood sugar. This is a condition that happens
when the kidneys produce extra urine. Water is partially regulated by antidiuretic hormone
(ADH) produced by the hypothalamus and released from the anterior pituitary gland when serum
osmolarity increases (Marilyn Sawyer Sommers, 2022). ADH acts on distal tubules of the
nephron by increasing pores for water reabsorption. Less ADH causes less or no reabsorption,
leading to the formation of dilute urine being excreted. Loss of solute-free water leads to mild
dehydration, a rise in plasma osmolality, and, thus, extreme thirst. It can be neurogenic or
nephrogenic. Neurogenic implies insufficient ADH is produced, while nephrogenic implies a
decreased response to ADH in the kidneys. Causes include neurosurgical procedures involving
the pituitary gland, neoplasms, malformations, infiltrative lesions, pituitary gland trauma, and
vascular changes such as stroke, aneurysm, infection, and pregnancy—some drugs, such as
lithium, demeclocycline, and amphotericin (Marilyn et al., 2022).
Additionally, diabetes insipidus can be genetically acquired. Arginine vasopressin has been
associated with neurohypophysis diabetes insipidus. Symptoms are similar to type II diabetes
with different mechanisms. Patients manifest with polyuria, polydipsia, and exhaustion due to
dehydration.
Conclusion
Diabetes is a chronic that can be treated but not cured. Early diagnosis and prompt management
are vital in preventing complications. For type diabetes mellitus, lifestyle modifications such as
diet management and exercise significantly help manage blood sugars. Additionally, gestational
diabetes should be carefully managed to avoid damage to the pregnant mother or unborn baby.
References
Hinkle, J. L., Cheever, K. H., & Overbaugh, K. (2021). Brunner & Suddarth’s textbook of medical-
surgical nursing (15th ed.). Philadelphia Wolters Kluwer Health, Lippincott Williams &
Wilkins.
Marilyn Sawyer Sommers. (2022). Davis’s diseases and disorders: a nursing therapeutic manual. F.A.
Davis Company.
Nelson, A. (2021, November 6). Diabetes Insipidus vs. Diabetes Mellitus. WebMD.
https://www.webmd.com/diabetes/diabetes-insipidus-vs-diabetes-mellitus
