Clinical patterns and complications of diabetes mellitus in India.

Introduction Diabetes mellitus till recently has beeen divided into two main types-the 'juvenile' and 'maturity onset'-on the basis of the age at onset, bodyweight, susceptibility to ketosis and response to insulin and oral therapy. Lawrence (1951) described a rare variety of lipo-atrophic diabetes characterized by earlier age of onset, loss of subcutaneous fat, rarity of ketosis and high insulin requirements. Hugh-Jones (1955) from Jamaica described the 'J-type' of diabetes mellitus which, although occurring in young and lean persons below 40 years of age, was not susceptible to ketosis, needed moderately large doses of insulin and did not respond to sulphonylurea compounds. Similar cases were later described from other tropical countries (Campbell & McNeil, 1959; Cosnett, 1959; Tulloch, 1962). Samaan & Fraser (1963) used the term 'thinmiddle-aged diabetes' for a group of subjects weighing 98-115% of standard weight, showing low typical and atypical serum insulin-like activity and responding to sulphonylurea and biguanide