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Management of diabetes mellitus 

Management of diabetes mellitus
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date: 16 November 2019

Type 2 diabetes—previously named ‘maturity-onset diabetes’ or ‘non-insulin-dependent diabetes mellitus’—was, in the past, generally diagnosed in individuals over the age of 40 years old, but, with the modern epidemic, is found in increasing numbers in younger people, including teenagers and children. It is strongly associated with overweight and obese individuals, and tends to run in families. This feature may be environmental, since being overweight also runs in families, but there are specific genes for obesity (1). Type 2 diabetes that occurs in younger individuals with a very strong family history of early-onset diabetes may be the autosomally dominant ‘maturity-onset diabetes of the young’ (MODY) (see Chapter 13.3.4).

In an environment where there is a pandemic of diabetes, one should maintain a very high level of suspicion of diabetes in those who are overweight—in the USA, the prevalence of type 2 diabetes is running at 8% of the population, and, in South India and Sri Lanka, at up to 18% in urban communities (2).

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