There are two principle forms of Diabetes. Type 1 Diabetes (formerly known as insulin-dependent), in which the pancreas fails to produce the insulin, which is essential for survival. This form develops most frequently in children and adolescents, but is being increasingly noted in later life.
Type 2 Diabetes (formerly named non-insulin-dependent), which results from the body’s inability to respond properly to the action of insulin produced by the pancreas. Type 2 Diabetes is much more common and accounts for around 90% of all Diabetes causes worldwide. It occurs most frequently in adults, but being noted increasingly in adolescents as well.
The symptoms of Diabetes may be pronounced, subdued, or even absent. In Type 1 Diabetes, the classic symptoms are excessive secretion of urine, thirst, weight loss and tiredness. These symptoms may be less marked in Type 2 Diabetes. In this form, it can also happen that no early symptoms appear and the disease is only diagnosed several years after its onset, when complications are already present. There are many complications that are associated with Diabetes Mellitus such as, Diabetic retinopathy. This is a leading cause of blindness and visual disability. Diabetes Mellitus is associated with damage to the small blood vessels in the retina, resulting in the loss of vision.
Diabetic neuropathy is the most common complication of Diabetes. Neuropathy can lead to sensory loss and damage to the limbs. It is also a major cause of impotence in diabetic men. The diabetic feet disease is due to changes in blood vessels and nerves, and this often leads to ulceration and subsequent limb amputation.
The mainstay of non-pharmacological diabetes treatment is diet and physical activity. About 40% of diabetes sufferers require oral agents for satisfactory blood glucose control, and some 40% need insulin injections. Frederic Banting and Charles Best isolated this hormone in 1921 in Canada. It revolutionized the treatment of diabetes and prevention of its complications, transforming Type 1 diabetes from a fatal disease to one in which long-term survival became achievable. People with Type 1 diabetes are usually totally dependent on insulin injections for survival. Such people require daily administration of insulin. The majority of people suffering from diabetes have the Type 2 form. Although they do not depend on insulin for survival, about one third of sufferers need insulin for reducing their blood glucose levels.
Large, population-based studies in China, Finland and USA have recently demonstrated the feasibility of preventing, or delaying, the onset of diabetes in overweight subjects with mild glucose intolerance (IGT). The studies suggest that even moderate reduction in weight and only half an hour of walking each day reduced the incidence of diabetes by more than one half. Diabetes is a serious and costly disease, which is becoming increasingly common, especially in developing countries and disadvantaged minorities. However, there are ways of preventing it and/or controlling its progress. Public and professional awareness of the risk factors for, and symptoms of diabetes are an important step towards its prevention and control.
