Q: What is the difference between diabetes that needs to be treated with insulin and the kind that just needs tablets?


A: Diabetes is a condition that develops when the body is unable to regulate the levels of sugar, specifically glucose, in the bloodstream. It develops when the body no longer adequately responds to insulin or when insulin production is too low.


There are two types:
Type 1, insulin-dependent diabetes, which always requires insulin for treatment;

Type 2, non-insulin-dependent diabetes, which can be controlled by diet alone or medication. But some people with type 2 may have a condition severe enough to merit treatment with injectable insulin.


Type 1 can develop at any age but is much more common in children and young adults. No insulin is produced naturally and, at present, can only be administered by injection. It is thought to be due to the body attacking its own cells, the Islets of Langerhans in the pancreas, which produce insulin, and is therefore known as an auto-immune disease.


Type 2 tends to develop later in life, usually over 40, but this is falling and some very overweight children are developing it. In type 2, the body becomes resistant to the effects of insulin. Together with lack of exercise, a BMI of more than 25 is a major risk factor for the development of diabetes. It is also more common in people of Afro-Caribbean or Asian origin. When this happens, the body cells can no longer make use of the glucose in the blood. The pancreas, where insulin is made, responds by producing more insulin, while the liver, which stores glucose as glycogen, releases more into the bloodstream to try to increase the amount of available glucose. Eventually, this process is inadequate and symptoms will develop. Glucose can be detected in the urine before symptoms develop. Picking up the condition as early as possible will reduce the many complications of the condition.


Further information about diabetes can be found from Diabetes UK on 0207 424 1030 or at www.diabetes.org.uk .


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