Assessment of medical impairment: problems v diabetes traumatic

The modern concept of diabetes is first considered, i.e a susceptibility to diabetes which can be inherited. The environment may then interact with this susceptibility to determine which persons actually develop clinical complaints and the timing of its onset. The clinical types of established potential and latent diabetics are described together with the proof required for trauma to be accepted as a cause of diabetes rather than exposing a previous diabetic or latent state. Despite an extensive search of the literature and questioning of experts both in Kenya and outside, in the absence of predisposing factors no evidence of trauma being the direct cause of the diabetic syndrome has been found. The one exception may be where there has been definite gross physical injury to the pancreas, but even in this case the evidence is scanty and not very convincing and such cases must be very rare. Trauma may precipitate latent diabetes and its complications and make control more difficult. A percentage assessment is suggested.