Diabetes causes serious complications such as:
- Kidney failure
- Loss of vision
- Nerve damage
- Heart disease
- Stroke
- Poor circulation leading to amputation
TYPES OF DIABETES
The existence of at least 2 clinical types of diabetes was first demonstrated convincingly 50 years ago by a distinguished Melbourne physician/biochemist, Professor Joseph (“Ginger”) Bornstein.
Bornstein developed an insulin bio-assay and showed there was no measurable insulin in the blood of “juvenile-onset” diabetics. This important finding preceded, by a decade, the Nobel Prize winning discovery of a more sophisticated technology in the insulin radio-immunoassay, which confirmed Bornstein’s earlier observations.
Diabetes is a collection of closely related diseases. The classification is based on differences in causation, natural history and clinical presentation. The two major categories of diabetes are:
Type 1 Diabetes (formerly known as insulin-dependent diabetes mellitus) is one of the most common childhood diseases in developed nations and constitutes about 10% of all persons with diabetes in Australia.
Type 1 Diabetes is believed to be caused by an autoimmune process which results in a slow destruction of pancreatic islet beta-cells by the body’s own immune system. The presentation is usually in young people but may occur at any age usually with a dramatic onset of:
- Extreme thirst and dry mouth
- Frequency of urination
- Sudden weight loss
- Blurred vision
- Infections eg skin boils, urinary tract infection
Type 1 Diabetes is the most common chronic disease of children but, with increasing obesity in children caused by lifestyle and dietary habits and the consequent increase in type 2 diabetes in children and adolescents, the order may be reversed within one to two decades.
Type 2 Diabetes (formerly known as non-insulin dependent diabetes mellitus) constitutes about 85% of all diabetes in Australia.
Type 2 Diabetes is mainly a lifestyle disorder highly associated with obesity and overweight and lack of exercise. There may be no symptoms at first for up to 5 years so early detection in people at high risk is warranted. Otherwise, there may be mild and gradual symptoms eg:
- Tiredness
- Mild thirst and frequency of urination
- Unexplained weight loss
- Infections
Type 2 Diabetes, which is not due to lack of insulin may occur at any age but appears more frequently in middle age. It is an important public health problem throughout the world. However most diabetics, both types 1 and 2, nowadays do not die from the metabolic abnormalities of diabetes but from cardiovascular and importantly atherosclerotic disease, renal disease and other complications caused by or contributed to by diabetes and/or obesity.
A disturbing trend is the increasing development of obesity and type 2 diabetes in children. This is symptomatic of the effects of globalisation and industrialisation affecting all societies, with sedentary lifestyle and obesity being the predominant factors involved. Part of the problem of treatment of type 2 diabetes in children relates to the fact that most pharmacological therapies for diabetes and its associated conditions are not approved for use in children with resultant high blood pressure and cardiovascular complications.
