Diabetes is a chronic disease that affects around 3% of the UK population - around 1.4 million people. There are two forms of diabetes:
Type 1 diabetes
- This type accounts for 15 to 20% of the total number of people with diabetes, around 400,000 people.
- Also referred to as insulin dependent diabetes or juvenile diabetes, it affects children and adults up to the age of forty. The number of children diagnosed under the age of 5 is markedly increasing.
- Type 1 diabetes is caused by the body's immune system attacking the insulin producing cells in the pancreas. The body no longer produces insulin and glucose levels rise and treatment with insulin injections is always required for survival. It is diagnosed as an acute condition.
- Around 25,000 people are treated with animal insulin and the remainder with synthetic 'human' insulin.
- There is no cure for Type 1 diabetes and cause has not been established. It is thought to be to be multi-factorial with a genetic link in some people. Recent research shows that a common virus may trigger the body's immune system to attack the pancreatic cells.
Type 2 diabetes
- This type of diabetes affects 80 to 85% of the total number of people with diabetes - about I million people and it is thought that there are a further 1 million people undiagnosed.
- Type 2 is also referred to as non-insulin dependent diabetes and it occurs mainly in people over the age of 40.
- In Type 2 diabetes, the pancreas still produces some insulin but it is not utilised properly by the various organs in the body.
- Type 2 diabetes can be treated with diet and exercise alone, oral blood glucose lowering drugs and if this still fails to reduce blood glucose levels sufficiently, then treatment with insulin is necessary.
- Type 2 diabetes can remain undiagnosed for several years during which time the blood glucose levels are too high and damage is being done.
- There is a tendency for Type 2 diabetes to run in families. The main cause is a sedentary lifestyle and overweight or obesity and therefore it is preventable for many people.
- The number of people affected by Type 2 diabetes is expected to double by the year 2010 due to the effects of lack of exercise, the increase in obesity and an ageing population.
The costs of diabetes to the NHS
According to the Office of Health Economics, the direct cost of treating diabetes in 1998/99 was estimated to be £320 million. If the costs of all the complications of diabetes are included, the cost has been estimated to be up to 10% of NHS resources. In financial terms this means a cost of £2.1 - £2.4 billion over and above the estimated cost of other illnesses that the elderly population is likely to have. The rapid increase in Type 2 diabetes is causing concern because of the likely escalating costs to the NHS.
The complications of diabetes
Type 1 and Type 2 diabetes are different diseases in cause, in effect and in treatment but the same long-term complications can arise in both types of the condition. The complications affect:
Diabetes can affect the blood vessels at the back of the eye [retinopathy] and this can lead to visual impairment or blindness. Diabetes is the leading cause of blindness in the working population.
The heart and vascular system
Diabetes can affect the heart and the vascular system making people more susceptible to heart disease and stroke. It can also cause blood clots in the vessels in the legs which may result in amputation. Amputations are 50-80 times higher in people with diabetes than the general population.
Diabetes can affect the kidneys resulting in damage or kidney failure [nephropathy].
Diabetes may cause nerve damage [neuropathy]. The most common form of nerve damage is in the extremities leading to pain or loss of sensation in the feet and ulceration of the legs. Again this can lead to amputation.
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