Your article on diabetes provided much useful information (Inaction on diabetes has plunged the UK into a wholly avoidable crisis, 13 April), but it is important to clarify one point. The symptoms mentioned (thirst, passing a lot of urine, unintentional weight loss) are particularly features of type 1 diabetes, which, as the article states, only accounts for about 8% of cases. The far commoner type 2 diabetes, linked to obesity, is frequently symptomless and may only be detected by chance during screening or on testing before operations, for example.
This lack of symptoms makes it a particularly pernicious condition as the body may be undergoing insidious damage over years without the person realising they have diabetes. This leads to the other major way in which the condition is detected, namely with problems with already damaged tissues such as eyes, nerves, kidneys or vascular systems. These changes may by then be irreversible. Absence of symptoms unfortunately does not rule out the possibility of diabetes.
Dr David Griffith
Moreton-in-Marsh, Gloucestershire
