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Diabetes mellitus (DM) is the most common endocrine and metabolism disorder of human. It can be seen worldwide. The problem is very common in daily clinical practice. Abnormal glucose metabolism is the important clinical feature of DM. DM can be seen at any age group and the management usually requires long term clinical care. Primarily, the diet control and life style modification is the general practice for management of DM. The use of antidiabetic drug and insulin are the main medications for management of the patients. The good patient compliance and long term close monitoring and follow-up is the main key factor for success in DM management. Without good DM control, the unwanted clinical complications such as vascular disorders at several organs (heart, brain, kidney, etc) can be expected. Burdens due to the DM are not uncommon and often seen in daily clinical practice. The complications of DM become the common cause of death of the people in several countries at present. Due to the increasing lost due to DM, the DM becomes the present public health issue for management. Many new researches and developments are ongoing in order to fight the problem due to DM.

In diabetic medicine, the classification of DM is important for planning for case management. In general, DM can be classified in type 1, type 2 or type 3. The management of each different type of DM is different and the pathogenesis of the disease is also different. Type 1 DM is the immunity related DM and the patient is usually pediatric. The type 2 DM is the DM of aging. The patient is usually an elderly with problem of degeneration. Type 3 DM is the specific new classification of DM with the strong relationship to Alzheimer’s disease [1]. Apart from the main 3 types of DM, there are also other varieties such as gestational DM which is the specific DM of the pregnant. In the recent year, the emerging new disorder namely “type 4 DM” was proposed. This is still no an official classification of DM but it is likely that this newest type of DM exists. The problem in yep 4 DM is seen in an elderly with lean appearance and has insulin resistance. As noted by Pérez-Tasigchana et al., “metabolic syndrome and insulin resistance were associated with increased risk of frailty [2].”

Type 4 DM may be a new term that is still not standard. Nevertheless, the type 4 DM is likely to exist and it might be under recognized. It has been found in the ongoing research that this type of diabetes is completely different from the one accompanied by the high blood glucose levels. In few cases there will be very high blood sugar levels and insulin functioning might not proper. This newest type of DM has just been proposed for a few years according to the new observation of a metabolism research group [3]. Of interest, the type 4 DM is not relating to and it is an actual interesting possible new type of DM. Further researches on this study are needed.

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