As we discovered over 40 years ago, diabetes is one word, but two different diseases. Type 1 diabetes, or insulin-dependent disease, is an autoimmune disorder in which the body does not produce insulin, the enzyme necessary for the body to metabolize sugar. Without insulin, sugar cannot move from blood into the cells, causing the blood sugar to rise above a safe level and leaving cells without the ability to function properly. It is a lifelong disease. Once diagnosed with the disease, patients with type 1 diabetes must carefully control of their blood sugar levels, using blood sugar monitoring many times a day in addition to daily insulin injection, for the rest of their life.
Type 1 diabetes increases the risk of a number of health complications, including accelerated heart disease, blindness, stroke, amputation, nerve damage, and kidney damage. In addition to these debilitating health complications, type 1 diabetics also have a tendency to acquire additional autoimmune diseases, such as hypothyroidism, rheumatoid arthritis, lupus and scleroderma.
Keeping the blood sugar level within a safe range by diet control, insulin injections, and regular exercise, has been the key to managing type 1 disease.
Type 2 diabetes, or non-insulin dependent disease, the most common form of diabetes, accounting for 90% of cases. Type 2 diabetes is linked with insulin deficiency or resistance-the body does not produce enough insulin or the cells ignore the insulin, causing a buildup of sugar in the blood.
The complications of type 2 disease are similar to those of type 1-cardiovascular disease, blindness, nerve damage, and kidney damage. In most cases, the disease is managed with lifestyle modifications, including diet control and exercise, alone. However, over time, patients with type 2 diabetes will become insulin dependent. Once this happens, they have the same projected lifespan and same risk of complications as those with type 1 disease. Disturbingly, type 2 diabetes-traditionally called adult-onset diabetes-is being diagnosed in increasingly younger children.
We are facing a diabetes epidemic. There are approximately 18 million people in the United States-a staggering 6% of the population-with diabetes. Nearly one-third of these people are unaware they have diabetes. And these numbers are growing. The incidence of both type 1 and type 2 disease has multiplied over the past twenty years, due in part to the increasingly sedentary lifestyle of Americans. Prediabetes, or glucose intolerance, a precursor to type 2 disease, is also at epidemic proportions, affecting approximately 16 million Americans.
Although, a cure for diabetes has not been found yet, great strides in treating both type 1 and type 2 disease have been made. For those who do not require insulin injection, diet modification and exercise can be used to help prevent and manage the disease. In addition, though it has not yet yielded a cure, the great amount of money invested in research has provided us with invaluable information that has advanced the treatment of diabetes. Already we have seen many improvements in the therapies used to treat the disease and in the quality of life and quality of care for those living with the diabetes. As innovative projects and dedicated researchers continue to expand our knowledge, the promise of a cure seems closer every day.
