Diabetes is a disease of glucose metabolism defined by elevated blood sugar. Diabetes physiology is well understood. Elevated blood sugars are the result of greatly diminished secretion of the hormone insulin by pancreatic islets of Langerhans or by diminished response to insulin by the body coupled with somewhat diminished secretion of insulin. The first type of diabetes is named "Insulin-Dependent Diabetes Mellitus (IDDM)",Type 1, and the second Type 1s named "Non-Insulin-Dependent Diabetes Mellitus (NIDDM).",Type 2. Cause of Type 1 The cause of IDDM (Type 1) is thought to be progressive and irreversible destruction of the islets by the diabetic's immune system. In the United States approximately 0.7% of the population will develop IDDM, most before age 25; hence the old name, "juvenile diabetes." At present there are 700,000 people with IDDM. All people with IDDM are treated with daily insulin injections, exercise, and diet; and with multiple daily blood glucose measurements. Cause of Type 2 The primary cause of NIDDM (Type 2) is thought to be "peripheral insulin resistance" (declining insulin sensitivity in the body, especially skeletal muscles) coupled with a secondary decline in insulin secretion by the islets of Langerhans. The root cause of insulin resistance is unknown. In the United States approximately 12% of the population will develop NIDDM, most after age 25; hence the old name, "adult diabetes." At present there are 16,000,000 people with NIDDM, most being undiagnosed. People with NIDDM are treated with exercise and diet; many take oral medication, some daily insulin injections, and some make blood glucose measurements. An estimated 700,000 people with NIDDM take insulin regularly. Consequences Diabetes is associated with retinal, renal, neurological and cardiovascular complications. It causes 24,000 new cases of blindness annually. Diabetes is the leading cause of end-stage renal disease and increases the risk for cardiovascular disease fourfold. Many of the complications of diabetes are associated with breakdown of the microvasculature. DCCT Study These vascular-related complications are preventable through tight management of diabetes. The Diabetes Control and Complications Trial (DCCT) showed that sustained reduction in glucose levels result in striking risk reduction (Figure below). Even more dramatic reductions are expected from the near-perfect glycemia provided by the Cerco Medical Bio-Artificial Pancreas.