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Those labouring with this Disease, piss a great deal more than they drink. Authors who affirm the drink to be little or nothing changed are very far from the truth, because the urine very much differed both from the drink taken in and also in being wonderfully sweet as if it were imbued with honey or sugar.


Diabetes comes from a Greek word meaning ‘to pass or flow through’ (i.e. excessive urination) and mellitus means ‘sweet’. It is a disease caused by a relative or absolute deficiency of insulin.

There are two main types of diabetes (see TABLE 11.1).

  • Type 1 is also known as juvenile onset diabetes or insulin dependent diabetes mellitus (IDDM).

  • Type 2 is also known as maturity onset diabetes or non-insulin dependent diabetes mellitus (NIDDM).

Table 11.1Clinical differentiation between type 1 and type 2 diabetes

Type 1 has an autoimmune causation which is also responsible for a late-onset form known as late onset autoimmune diabetes in adults (LADA).


The onset of type 2 diabetes can be subtle and by stealth. In 2014–15, around 1.2 million (5%) Australians had diagnosed type 2 diabetes1 and another 500 000 (2.1%) were estimated to have type 2 diabetes but were not yet diagnosed.2 A further 2 million (8.4%) had impaired fasting glucose or impaired glucose tolerance. Around half of those with type 2 diabetes have complications (when microalbuminuria is included), many of whom already have a complication at the time of diagnosis. The challenge for GPs is to be on constant lookout for these individuals, especially those at risk. Type 2 diabetes is becoming more prevalent in industrial countries—due to the ageing population, broadened diagnostic definitions and because our lifestyle encourages us to ‘eat more and walk less’.3 Furthermore, roughly 60% of our population are overweight or obese.

Complications occur in both type 1 and type 2 diabetes.

  • Several causes of secondary diabetes are uncommon (pancreatic disease; approx. 2.5%) or very uncommon (see TABLE 11.2).

  • Asymptomatic people at high risk of undiagnosed diabetes should be screened ...

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