Etiology and pathogenesis of diabetes mellitus

The concept that diabetes mellitus is not a single disease. but rather a clinical syndrome characterized by inappropriately elevated fasting or post-prandial blood glucoses and the development of long-term microvascular, macrovascular, and neuropathic changes is of very recent origin and stems from numerous investigations into the epidemiology, genetics, etiology, and pathogenesis of clinical diabetic states. This article reviews some of these data and indicates that the various forms of diabetes mellitus have markedly different etiologies and pathogenetic mechanisms and that these must be recognized in order to understand and care for patients.