Diabetes and Insulin Therapy
The one between insulin-dependent diabetes and insulin-independent diabetes is a distinction made in the attempt to classify the various forms of diabetes mellitus, based on the need or not to resort to replacement therapy with insulin.
First of all it should be clarified that any form of diabetes mellitus may require continuous or occasional insulin therapy, whatever its stage; therefore, the use of insulin by itself cannot classify the patient. Therefore the traditional definition, in many respects still in vogue, which attributes the insulin-dependent adjective to type I diabetes, or juvenile, and the insulin-independent adjective to type II or senile diabetes, appears inappropriate.
Age and Diabetes
In reality even the juvenile or senile adjective is inappropriate, given that type I diabetes is an autoimmune disease, which usually appears in childhood and manifests itself in puberty. The total or sub-total destruction of pancreatic beta cells, which results, necessitates chronic injection of insulin for therapeutic purposes, hence the term insulin-dependent (without insulin the disease would be fatal).
Type II diabetes, on the other hand, usually arises in the mature age and is often shown randomly during blood tests (hyperglycemia); it is typical, but not exclusive, of overweight people, it arises gradually and in the advanced stages there is always a more or less severe insufficiency of insulin. Therefore, although in most cases the treatment foresees the simple intake of oral hypoglycemic agents (hence the adjective insulin-independent), also type II diabetes mellitus may require occasional insulin treatment (for example in conjunction with major stress, both physical or psychological, such as trauma, myocardial infarction, acute cerebro-vascular episodes), or continued.
