According the World Health Organization in 2006 there were 171 million sufferers world wide, and that's a figure that estimated to double by the year 2030. Diabetes Mellitus occurs through out the world, but is more common in the civilized countries. The greatest increase anywhere at the moment is in Africa, and Asia.

History.

Although diabetes has been recognized since antiquity, and various forms of treatments have been known since the Middle Ages, and it has only been understood experimentally since about 1900.

The discovery of a role for the pancreas in diabetes is generally ascribed to Joseph von Mering and Oskar Minkowski, who in 1889 found that dogs whose pancreas was removed developed all the signs and symptoms of diabetes and died shortly afterwards. In 1910, Sir Edward Albert Sharpey-Shafer suggested that people with diabetes were deficient in a single chemical that was normally produced by the pancreas-he proposed calling this substance insulin, from the Latin insula, meaning island, in reference to the insulin-producing islets of Langerhans in the pancreas.

After that is was Sir Fredrick Grant Banting, and Charles Herbert Best who repeated the work of the two gentleman above in 1921 where they clarified the work on the pancreas, and the existence of insulin. By doing experiments they could induce diabetes in dogs, and then in turn reverse it by giving them an extract from the pancreatic islets of Langerhans from healthy dogs.

Two years later Banting and Best both received the Noble Prize for their work. After this Insulin production was stepped up, and it wasn't long before it spread through out the world.

Diabetes screening is recommended for many people at various stages of life, and for those with a certain risk factor. The screening test varies according to circumstances and local policy. Many healthcare providers recommend universal screening for adults at age 40 or 50, and often periodically thereafter. Earlier screening is typically recommended for those with risk factors such as obesity, or a family history of diabetes.

Many medical conditions are associated with diabetes and warrant screening. A partial list includes: high blood pressure, high cholesterol levels, coronary artery disease, past gestational diabetes, etc. The risk of diabetes is higher with chronic use of several medications, including high-dose glucorticoids, some chemotherapy agents (especially L-asparaginase), as well as some of the antipsychotics and mood stabilizers.

Diabetes is often detected when a person suffers a problem frequently caused by diabetes, such as a heart attack, stroke, neuropathy, poor wound healing, or a foot ulcer, or certain eye problems.

According to the American Diabetes Association, approximately 18.3% (8.6 million) of Americans age 60 and older have diabetes. Diabetes mellitus prevalence increases with age, and the numbers of older persons with diabetes are expected to grow as the elderly population increases in number. The National Health and Nutrition Examination Survey (NHANES III) demonstrated that, in the population over 65 years old, almost 18% to 20% have diabetes.

Regarding another study more than 40% of Americans 65 yr and older meet diagnostic criteria for type 2 diabetes. Older Americans are also more likely to have complicating conditions such as retinopathy, hypertension, and kidney problems.

The way diabetes is managed changes with age. Insulin production decreases because of the age-related impairment of pancreatic beta cells. Insulin resistance increases due to the loss of lean tissue and the accumulation of fat, particularly intra-abdominal fat, and the decreased tissue sensitivity to insulin. Glucose tolerance progressively declines with age, and there is a high prevalence of type 2 diabetes and postchallenge hyperglycemia in the older population. Age-related glucose intolerance in humans is often accompanied by insulin resistance, but circulating insulin levels are similar to those of younger people.

Researchers and clinicians agree that treatment goals for older patient with diabetes need to be individualized and take into account health status, as well as life expectancy, level of dependence, and willingness to adhere to a treatment regimen. Following evaluation, one of two levels of care can be recommended: symptom-preventing care or aggressive care. The decision is made jointly by the patient and the primary caregiver.