Type 2 Diabetes

· Type 2 diabetes is a metabolic disorder that results from the body's inability to make enough, or properly use, insulin. (1)

· Like type 1 diabetes, type 2 diabetes is characterised by high blood glucose levels. However, the predominant cause of type 2 diabetes is insulin resistance rather than insulin deficiency. (2)

· Treatment does not necessarily require insulin, and many people, particularly in the initial years following diagnosis can be successfully managed with dietary and general lifestyle modification alone or in combination with oral therapy. (2)

· Insulin therapy may be required for type 2 diabetes if and when oral medication becomes ineffective in lowering and maintaining the blood glucose within an acceptable range. (2)

· Type 2 diabetes occurs most often in middle-aged adults and accounts for 85 percent of all diabetes cases. (2)

· Findings from the International Diabetes Institute Study (AusDiab) highlighted that nearly 1 in 4 Australian adults has either diabetes or a condition of impaired glucose metabolism, which is associated with substantial increased risk of both future diabetes and heart disease. (3)

· The AusDiab study also found that Australian diabetes rates have trebled in the past 20 years, ranking Australia as having one of the highest diabetes rates among developed countries. (3)

· Recent statistics show 900,000 Australians have diabetes although 50% of these cases remain undiagnosed. (4)

· Findings from the United Kingdom Prospective Diabetes Study (UKPDS), a landmark 20-year study of treatment for patients with type 2 diabetes, demonstrate that maintaining blood glucose close to normal may significantly reduce the risk of complications associated with diabetes. The study found that patients on drug therapy to control blood glucose experienced a 21 percent decrease in eye disease and 33 percent decrease in kidney problems. (5)

Complications associated with diabetes

· Diabetes is the leading cause of blindness in adults under the age of 60 years. (4)

· Heart and circulation problems are the leading cause of death among people with diabetes, accounting for 65 per cent of deaths. Fifteen per cent of people with diabetes have diagnosed heart disease compared to 2.5 per cent of people without diabetes. (4)

· Diabetes is the leading cause of non-traumatic amputation. One in 4 people with diabetes have peripheral neuropathy (nerve disease) and approximately 1 in every 100 has had an amputation. (4)

· Diabetes is the 7th leading cause of death in Australia although it is generally believed that death certificates under-report diabetes as a cause or major contributing factor to death. (4)

Risk Factors

People most at risk of diabetes are:

Over 50 and:
- Overweight
- Have high blood pressure
- A family history of diabetes

Over 65 and:
- Have heart disease
- Developed diabetes during pregnancy
- Had a borderline blood glucose test

References

1. Diabetes Dictionary, Diabetes Centre Australia, http://www.diabetes.org.au/glossary.htm
2. NHMRC report, National Evidence Based Guidelines for the Management of Type 2 Diabetes Mellitus, December 2001, p.1
3. Dunstan D, Zimmet P, Wellborn T et al. Diabesity and Associated disorders in Australia 2000: The accelerating epidemic. The Australia Diabetes, Obesity and Lifestyle Study (AusDiab). International Diabetes Institute, Melbourne 2001
4. Colagiuri, S, Colagiuri R, Ward J. National Diabetes Strategy and Implementation Plan. Diabetes Australia, Canberra, 1998
5. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33), Lancet 1998; 352: 837-53
6. Defuse Diabetes Campaign 1999. http//partners.health.gov.au/mediarel/yr1999/mw/mw99108.html