Diabetes

Diabetes is the classic 21st century disease. Known as a medical condition for thousands of years, it has risen in Western countries to almost epidemic proportions in the last 50 years. According to the American Diabetic Association, 7% of the American population, 20.8 million children and adults, currently suffer from various forms of diabetes. At least one third of this number, or 6.2 million people, are undiagnosed, and unaware of the damage that complications of diabetes can cause.

The term diabetes actually includes several different syndromes, each with different risk factors and causes. As research continues, more sub-types are discovered, and treatments become more specific, with many clinics specialising in diabetic treatment and prevention.
Today the main types of diabetes are classified as Type 1, or juvenile diabetes, Type 2, or adult onset diabetes, and gestational diabetes, which is diabetes which begins in pregnancy. The common factor in all types of diabetes is an uncontrolled rise in blood sugar and an inability to metabolise this sugar into energy usable by cells. However, the reasons for this in Type 1 are completely different to the reasons in Type 2 and gestational diabetes, and the disease acts quite differently.

Type 1 diabetes

In Type 1, cells in the pancreas which produce insulin are believed to be destroyed by an immune reaction. Insulin is a hormone responsible for mediating cell uptake of blood sugar, and the sudden lack of insulin causes an acute disease which is usually easily diagnosed. According to the American Diabetic Association, between 5-10% of Americans diagnosed with diabetes belong to this group.

Type 2 diabetes

In Type 2 diabetes the picture is quite different. Most undiagnosed diabetics suffer from this type of diabetes, which is by far the most common in Western countries. Type 2 diabetes is caused by several different factors which act together to cause a gradual rise in blood sugar. The most important factors are an increase in weight which increases the amount of insulin needed to control blood sugar levels, a decrease in sensitivity to insulin by cell receptors, and sometimes a decrease in insulin production in the pancreas. Unlike Type 1 diabetes, which is usually diagnosed days or months after onset, Type 2 diabetes can exist for many years without detection, and often only when complications become troublesome enough to need treating the disease is discovered. Due to routine tests, women who develop gestational diabetes, which is similar in behaviour to Type 2 diabetes, are usually diagnosed, and can avoid complications by adhering to a strict treatment routine and diet. Gestational diabetes affects about 4% of pregnant women in America.

Treatments and prevention

Although good treatments exist for diabetes, the emphasis in diabetes treatment today is prevention. 41 million Americans are pre-diabetic, meaning that their blood sugar levels show abnormalities which will lead to diabetes if untreated. Since much of the treatment for pre-diabetes consists in life style changes, long term education programs encouraging exercise, healthy diet and keeping excess weight off are essential in order to combat this modern plague.