jwb@mcnc.UUCP (Jack W. Buchanan Jr.) (03/07/84)
The terms juvenile onset and adult onset have been replaced by "insulin dependent" and "insulin independent" or insulin resistant, respectively. Some of this is still controversial, but the current thinking is that for insulin dependent the defect is in the machinery to make insulin while for insulin independent the defect is either the sensor which determines circulating glucose level or at the cell where the insulin is utilized (i.e. it is not clear whether insulin independent diabetics usually have low, normal, or high circulating insulin levels. Both types are now thought to have both genetic and environmental components. There are other, much rarer, forms of insulin where the defect can be at just about any conceivable location. These are mostly genetic. General references: Harrison's or Cecil/Loeb Textbook of Medicine Reference consulted to verify above:Goodman, Gillman: The Pharmacological Basis of Therapeutics, Sixth Edition, Macmillan, 1980