Type 1 is characterized by the destruction of beta cells in the pancreas, typically to an autoimmune process. The result is the absolute destruction of beta cells, and causes insulin to be absent or extremely low.

Type 2 involves a more insidious onset where an imbalance between insulin levels and insulin sensitivity causes a deficit of insulin. Insulin resistance is multifactorial but commonly develops from obesity and aging.

Genetics plays a role in development of both diseases

Symptoms may begin as a mild ache or stiffness in the back of the leg or above the heel after activity. Overtime this pain may increase and occur during/after running, jumping, stair climbing or sprinting.

Type 1 Treatment: Since the disease is primarily due to the absence of insulin, insulin administration through daily injections, or an insulin pump.

Type 2 treatment: diet and exercise may be adequate treatments in early stages. Other medication therapies may target sensitivity or increase insulin secretion by the pancreas.

Untreated this disease has serious complications involving microvascular structures - affecting the eye, kidney, and lower extremities.

In the setting of podiatry regular foot screenings are essential for limb preservation.