The recent AusDiab data show that 7.2% of Australians over 25 years of age have type 2 diabetes mellitus and a further 16.1% have impaired glucose tolerance. In fact, 20% of Australians over 65 years have type 2 diabetes and it is well known that morbidity and mortality are significantly increased in affected patients.1,2 However, there is evidence from the United Kingdom Prospective Diabetes Study (UKPDS) that good glycaemic control can improve morbidity by improving microvascular complications of type 2 diabetes, such as retinopathy, nephropathy and neuropathy3 (E2). (See Box 1 for an explanation of level-of-evidence codes.) There is a well-recognised and strong association of type 2 diabetes with obesity and the insulin resistance syndrome. "Syndrome X"5 refers to a collection of pathophysiological sequelae resulting from insulin resistance and includes type 2 diabetes, as well as hypertension, dyslipidaemia, hyperuricaemia and elevated plasminogen-activator-inhibitor-1 levels.6
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