NonInsulinDependent

Noninsulindependent, also written as non-insulin-dependent diabetes mellitus (NIDDM), is a historical label used to describe a form of diabetes mellitus that does not require insulin therapy at diagnosis to control blood glucose. The term roughly maps to what is now known as type 2 diabetes mellitus (T2DM). However, the use of this term is imprecise, because some people diagnosed as noninsulin-dependent eventually require insulin, and some individuals with other forms of diabetes may need insulin early.

Pathophysiology: Noninsulin-dependent diabetes is characterized by insulin resistance in liver, muscle, and adipose tissue, accompanied by progressive pancreatic beta-cell dysfunction that reduces insulin secretion. This leads to hyperglycemia with relative, rather than absolute, insulin deficiency. Unlike type 1 diabetes, it is not primarily autoimmune destruction of beta cells.

Clinical features and management: It typically presents in adulthood and is associated with obesity, metabolic syndrome, and sedentary lifestyle. Symptoms may be mild or nonspecific. Initial management emphasizes lifestyle modification (weight reduction, physical activity) and pharmacologic therapy, often starting with metformin and other oral agents (sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, or GLP-1 receptor agonists); insulin may be required later in the disease course or during illness or stress.

Terminology and status: The label noninsulindependent is largely obsolete in modern medical usage, which uses type 2 diabetes mellitus. The historical term remains encountered in older literature and some regional contexts.

See also: Type 2 diabetes mellitus, diabetes mellitus, insulin therapy.