Mechanisms of pathogenesis in diabetes mellitus

Diabetes mellitus is a syndrome of complex etiology and pathogenesis involving abnormal insulin synthesis, release, binding, and target cell activation. These are manifested differently in the two most common forms of this disease: insulin-dependent diabetes mellitus (IDDM) and noninsulin-dependent diabetes mellitus (NIDDM). Although there still remains much to be discovered to complete our understanding, significant contributions have been made in the last few years by molecular genetics and immunology. This paper reviews many of these facets in contrast to others, which deal primarily with issues of management.