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The Impact of Type1 and Type2 Diabetes

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The condition and impact of diabetes mellitus may have been in existence for more than three thousand years. The two forms of diabetes were first described in the fifth century AD, one occurring in slim individuals who perished quickly (Type 1 diabetes) and the other in older overweight people who survived for longer (Type 2 diabetes). By the end of the nineteenth century, Langerhans from Berlin had described small clusters of cells (islets of Langerhans) in the pancreas gland that were later found to be responsible for the production of a glucose-lowering hormone. The greatest break through in the management of diabetes occurred in 1921 when insulin was discovered at the University of Toronto by the surgeon Frederick Banting and his student Charles Best. This led to insulin being manufactured and used for the treatment of diabetes. Diabetes mellitus is a condition in which there is a persistent elevation of blood glucose concentration. It can be caused by reduced insulin action and/or insufficient amounts of insulin.

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Type 1 diabetes can occur at any age but more commonly present in children and young adults. It currently accounts for 5% of diabetes in developing countries and 15% of diabetes in Europe and North America. In most cases it is caused by an autoimmune destruction of the β-cells of the islets of Langerhans cells that are located in the pancreas gland. These cells produce the hormone insulin and their destruction leads to an absence of insulin production and secretion.

Type 2 diabetes has traditionally been considered a disease of the middle-aged or elderly but is now increasingly seen in younger adults and even children, due primarily to increasing rates of obesity. The majority of patients (80–85%) are obese. Obesity and a sedentary lifestyle are thought to be responsible for the dramatic increase in prevalence of this condition. Type 2 diabetes is caused by impaired insulin secretion and by resistance to the action of insulin in peripheral tissues.

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