DM 1 usually occurs in children and young adults and is often called juvenile onset diabetes. Onset of the disease is abrupt. The patient becomes very sick and requires immediate insulin therapy. Approximately 1 million people in the United States have DM 1. DM 2 usually occurs in adults over the age of 40 who are overweight and have a family history of the disease.
Some patients can manage their diabetes with weight loss and changes in their diet.
Others require medication, and many with DM 2 eventually require insulin. Onset is gradual, and patients may be sick for quite some time without knowing it. Patients in stage 2 excrete more than 30 mg of albumin in the urine over a 24-hour period. Glomerular damage has progressed to clinical albuminuria. Glomerular damage continues, with increasing amounts of protein albumin in the urine.