Diabetes mellitus
Contents
What is diabetes mellitus?
Diabetes mellitus is a chronic condition in which the body makes too little of the hormone insulin or cannot use it properly. Insulin is produced by the pancreas and helps glucose (sugar) enter cells from the bloodstream to be converted into energy. In uncontrolled diabetes, there is an inadequate supply of glucose to the cells and a build-up of glucose in the bloodstream. This can lead to a range of disturbances affecting the heart, brain, kidneys and other parts of the body.
Because the common feature of diabetes is high blood glucose, it is often mistakenly thought to be a single disease. There are actually several types of diabetes, with different causal mechanisms. The three main types: are Type 1, Type 2 and gestational diabetes.
Type 1 diabetes is marked by a total or near-total lack of insulin. It results from the body destroying its own insulin-producing cells in the pancreas. People with this form of diabetes require daily insulin therapy. It is the most common cause of childhood diabetes and accounts for 10-15% of all people with diabetes in Australia. Around 0.2-0.3% of the Australian population have Type 1 diabetes.
Type 2 diabetes is marked by reduced levels of insulin, or the inability of the body to use insulin properly (insulin resistance). The disease is most common among people aged 45 and over, and accounts for 85-90% of all people with diabetes. According to the AusDiab survey, conducted in 1999-2000, more than 7% of Australians aged 25 years or over have Type 2 diabetes. Many people with this form of diabetes eventually need insulin therapy to control their blood glucose levels.
Gestational diabetes occurs during pregnancy in about 3-8% of females not previously diagnosed with diabetes. Screening tests for gestation diabetes are usually performed around the 24th-28th weeks of pregnancy. It is a transient form of diabetes and usually disappears after the baby is born. However, it is a marker of increased risk to develop Type 2 diabetes later in life. Some women with this type of diabetes need insulin therapy to control their blood glucose levels.
Why is diabetes mellitus a National Health Priority Area?
Diabetes mellitus and its complications contribute significantly to ill health, disability, poor quality of life and premature death. Additionally, diabetes mellitus is a contributing factor to several other causes of morbidity and mortality. It also increases the risk of a variety of complications including end-stage kidney disease, coronary heart disease, stroke and other vascular diseases.
In 2003, diabetes was the eighth and tenth leading underlying cause of death in Australia among males (1,807) and females (1,582) respectively. It was also the fifth most frequently managed problem by general practitioners in Australia in 2003-04.
Diabetes mellitus was responsible for just under 5% of the burden of disease in disability-adjusted life years in Australia in 1996. In monetary terms, the direct costs of diabetes mellitus and its complications were estimated at $836 million in 2000-01 and this is expected to increase as the population ages.