Question:What is the relationship between age and the risk of developing type 1 and type 2 diabetes?
Answer:We divide diabetes broadly into two types, one's called type 1 and one's called type 2. It's an arbitrary division, but type 1 is a disease in which your own body destroys your insulin-secreting cells, the islets; this is an immune abnormality. And it used to be called 'juvenile onset' diabetes because mostly children would get this. But then people became aware, as the years went on and research continued, that in fact you could get this same disease when you were 92. But what happens is, when you're 20, 30, 40, 60, 80, the process of destroying the islets seems to occur more slowly. So it was confusing for years, but now we know it's the same disease. So therefore, although it's most common in children, you can still get type 1 diabetes as you get older.
On the other hand, the other type of disease we talk about is type 2 diabetes, and that's where your insulin-secreting cells are still there, but they're dying. And we don't actually know why they're dying, but something about them is making them die, perhaps because they have to secrete too much insulin. And as people get older, for a variety reasons -- and the most common is obesity and a sedentary lifestyle. Therefore, each of us has a certain ability to secrete insulin, and generally the older we get, the more of a challenge that is. But there are some people who are 20 or 30, who are very overweight, or even 10 or 15 tragically, who are so overweight that their islets are already 'giving out.' So they actually have type 2 because it's not an immune abnormality, it's not that their own immune system is killing them, it's the distress -- plus their genetic background -- is making these islets run out of gas.