Key facts and checkpoints

• The prevalence of diabetes is about 3% of the adult population (includes about 1% undiagnosed).

• A further 3% will have impaired glucose tolerance. 1

• About 30% of these people will develop clinical diabetes within 10 years. 1

• Many type II diabetics are asymptomatic.

• Diabetes can exist for years before detection and complications may be evident.

• Type II diabetes is not a mild disease. About one-third of those surviving 15 years will require insulin injections to control symptoms or complications. 2 Complications occur in type II diabetes as well as in type I.

• There are several causes of secondary diabetes that are very uncommon (see Table 17.2).

Table 17.2 Causes of secondary diabetes

Endocrine disorders

• Cushing's syndrome

• acromegaly

• phaeochromocytoma

Pancreatic disorders

• haemochromatosis

• chronic pancreatitis

Drug-induced diabetes (transient)

• thiazide diuretics

• oestrogen therapy (high dose—not with low-dose HRT)

• corticosteroids Other transient causes

• gestational diabetes

• medical or surgical stress

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